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2015 User Conference Keeping Your Eye on the Prize$ April 23rd, 2015 Presented by: Rena Lefkowitz Director of Training PM Session.

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Presentation on theme: "2015 User Conference Keeping Your Eye on the Prize$ April 23rd, 2015 Presented by: Rena Lefkowitz Director of Training PM Session."— Presentation transcript:

1 2015 User Conference Keeping Your Eye on the Prize$ April 23rd, 2015 Presented by: Rena Lefkowitz Director of Training PM Session

2 2015 User Conference Keeping Your Eye on the Prize$ April 24th, 2015 Presented by: Jen Novakovich PM/EHR Trainer PM Session

3 2015 Office Practicum User Conference Objectives ❏ Tracking financial processes in your Practice ❏ Ensure correct information is obtained ❏ Capture all charges ❏ Ensure clean claims are processed

4 2015 Office Practicum User Conference What players are involved?

5 2015 Office Practicum User Conference Appointment Superbill creation during visit Claim creation Claim tracking and Collections Financial Visit Cycle

6 2015 Office Practicum User Conference Survey What gets missed? Appointment

7 2015 Office Practicum User Conference Appointment Where we can ensure better accuracy: ❏ Correct insurance information ❏ Verify and Validate ❏ Rank!! ❏ Selecting financial guarantor ❏ Copays/deductibles ❏ Previous balances ❏ Self Pay Charges

8 2015 Office Practicum User Conference Obtaining Correct Insurance Information Appointment ❏ Verify at each visit ❏ Validate prior to visit ❏ Always rank! ❏ Select financial guarantor

9 2015 Office Practicum User Conference Check In Appointment ❏ Confirm financial responsibility ❏ Workflow for collecting balances ❏ Review Misc or Billing account notes ❏ Ensure accurate insurance information

10 2015 Office Practicum User Conference Survey What is often missed? Superbill creation during visit

11 2015 Office Practicum User Conference Where we can ensure better accuracy: ❏ All work documented in OP ❏ NEW procedure templates ❏ Coding completed at the time of visit Superbill creation during visit

12 2015 Office Practicum User Conference Documenting all work in OP Superbill creation during visit ❏ Manually typed in, this will not create a superbill charge “If it is not documented it is NOT done.” ❏ Task created, once staff completes task order will process to superbill

13 2015 Office Practicum User Conference Procedure Templates

14 2015 Office Practicum User Conference Coding Visits

15 2015 Office Practicum User Conference Superbill creation during visit Workflows? ❏ Diagnostic tests ❏ Vaccines ❏ Surveys ❏ Procedures ie; nebulizer, cerumen removal

16 2015 Office Practicum User Conference Survey Missing?? Claim creation

17 2015 Office Practicum User Conference Where we can ensure better accuracy: ❏ Review superbills/claims ❏ Payer specific code requirements ❏ Blocked and Substituted codes ❏ Tracking % of each level of visits to prevent audit Claim creation

18 2015 Office Practicum User Conference Reviewing Superbills/Claims for Accuracy Claim creation

19 2015 Office Practicum User Conference Reviewing Superbills/Claims for Accuracy Claim creation

20 2015 Office Practicum User Conference Payer Specific Codes Claim creation ❏ Correct Immunization Administration ❏ NDC codes required? ❏ 25 modifier on a well visit visits? ❏ 33 modifier on the preventive codes

21 2015 Office Practicum User Conference Blocked and Substituted Codes Claim creation

22 2015 Office Practicum User Conference Tracking % of Each Level of Service Claim creation

23 2015 Office Practicum User Conference Survey What is overlooked? Claim tracking and Collections

24 2015 Office Practicum User Conference Where we can ensure better accuracy: ❏ How often are payments posted? ❏ How often is A/R worked? ❏ Is there a workflow for collection calls ❏ Rejection correct in a timely manor? ❏ How often are statment run? Claim tracking and Collections

25 2015 Office Practicum User Conference Payment Posting Claim tracking and Collections ❏ Save time! Try posting through the Bulk Payments

26 2015 Office Practicum User Conference A/R Claim tracking and Collections

27 2015 Office Practicum User Conference Collections Claim tracking and Collections

28 2015 Office Practicum User Conference Rejections Claim tracking and Collections

29 2015 Office Practicum User Conference Statements Claim tracking and Collections

30 2015 Office Practicum User Conference Claims Cycle Appointment Superbill charges posted claim created Claims transmitted to clearinghouse Insurance processes claims

31 2015 Office Practicum User Conference Questions ?

32 2015 Office Practicum User Conference What three things stuck with you?

33 2015 Office Practicum User Conference

34 We want your feedback!


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