Commensurate with the new year, it is considered best practice to review your practice's goals, policies and procedures and communicate them to your staff. Below is a short checklist of 10 key items that every practice should review annually to ensure their practice and billing performance for the new year kicks off on the right foot...
From your friends at StreamlineMD...
2019 Top 10 Billing Checklist
- Billing Goals - Meet with your billing team/company to review 2018 performance and set goals for 2019.
- Payer Contracts - Review your major payor contracts to see if and how your allowed amount fee schedule may change in the upcoming year
- Compliance Plan - Review Compliance Plans (HIPAA and OIG) and ensure your staff receive training at least annually
- Physician Documentation - Review physician documentation standards to for completeness and accuracy to meet today's standards
- 2019 CPT Codes - Review 2019 CPT book for your frequently performed cases to understand the language that coders and payers will be looking for.
- MIPS - Check your QPP Participation Status at (https://qpp.cms.gov/participation-lookup). If you are eligible to participate, pick your MIPS registry and identify which quality measures you plan to follow this year.
- Patient Registration - Office practices - review your front desk scheduling, patient registration, insurance verification, and time of service payment policies and procedures to ensure you capture accurate patient information and collect as much as possible from the patient at the time of service.
- Visit-to-Claim Reconciliation - Review your process of reconciling patient scheduling, documentation, coding and charge capture workflow to ensure no claims are left behind. Hospital practices, confirm that your hospital is transmitting not just reports and patient demographics electronically, but also department logs. This is important to complete a full patient reconciliation to ensure no claims fall through the cracks.
- Denial Review - Review your previous year’s most frequent claim denial reasons and take steps to eliminate them. Office practices, ensure that referring physicians provide timely and complete prior authorization and reason for the visit. Hospital practices - Meet with your hospital representative to review denials that stem hospital processes such as lack of prior authorization, medical necessity due to missing signs/symptoms on orders, or invalid insurance.
- Patient Refunds - Review your patient refund policy and confirm that you have submitted your unclaimed funds report to your state, if applicable.
Taking these steps in the first couple weeks of each year will ensure that you get off to a good start and optimize your overall practice performance for the coming year. If you have any questions, please contact your StreamlineMD client rep or sales at 866-406-2224.
To learn more about how StreamlineMD can help your practice prosper in 2019, see www.streamlinemd.com.