How to Create a Superbill That Works for Your Cardiology Practice, Not Against It
Published on Thu Apr 01, 1999
It clearly pays to maintain a well-designed superbillan outdated one can cause denials, trigger an audit, and keep your practice from receiving all the reimbursement to which it is entitled.
However, even if youre retaining the same basic design, updating the contents of a superbill takes time and effort. Often practices put it off to their own detriment.
Here are some content and design tips to help your cardiology practice. Use the following checklist to enhance reimbursement, avoid auditors, and decrease denials:
1. Are you using the most current diagnostic, procedural, and HCPCS Level II codes? If youre not updating every year when the new codes are released in the late fall, then your form is obsolete, warns Sue Moore, CCSP, CMM, CMA, business office manager at Heart Specialists of Northwest Ohio, a 15-member group of general, invasive and EP cardiologists.
Barbara J. Cobuzzi, MBA, CPC, agrees. Updating annually is the first and foremost rule of maintaining a good superbill, stresses the president of Cash Flow Solutions, a batch biller in Lakewood, NJ, who conducts superbill audits for her clients.
Ive seen practices continue to submit truncated or deleted codes for several years running, she says. [An obsolete superbill] not only causes them to experience more denials because they arent representing their services accurately, but they could also be losing money since they may be missing the opportunity to bill for something.
Cobuzzi suggests revising the superbill during the last two weeks of the year. At this time, all the new codes have been released, and the patient base is lower than usual, so the billing department isnt having to process as many payments, she explains. That way, you can find some time to work it into your schedule before the new codes take effect at the first of the year.
But Moore says that the process at Heart Specialists takes longer because she involves others in the practice. In addition to going through the code books and noting revisions, deletions, and additions, I also ask the lab and the nuclear technicians to revise their particular sections, she says. Then, I have two of the cardiologists review the rough draft.
2. Does the superbill list the complete range of Evaluation and Management (E/M) codes? Vying for first place in the update checklist is making sure the forms contain all levels of the E/M codes for new patient (99201-99205), established patient (99211-99215), and consultations (99241-99245).
Not having all five levels is a red flag for an auditor, warns Joseph Greco, CEO of Professional Systems, a healthcare printing firm in Plymouth Meeting, PA, that maintains a library of sample superbills for cardiology practices and other specialties. (For information on the design, printing and support of superbills, contact Professional Systems [...]
