Gastroenterology Coding Alert

If you don’t regularly scrutinize your accounts receivables, you’re probably losingthousands.

You’ve stayed on top of the coding changes, educated your doctors about new coverage decisions and updated your electronic billing systems periodically — so you should be collecting all the money you deserve, right? Not always. Without a way to keep your accounts receivable (A/R) process on track, you could be bleeding cash.

A/R defined:  Accounts receivable (A/R) is the money that is owed to the practice. If you aren’t aware of what your A/R looks like at any given time, you are leaving out an important piece of the collections puzzle. Follow these five best practices to set your practice on an improved A/R track and avoid thousands in lost reimbursement.

1. Remove Untimely Claims From the Workflow. You should review all claims and if any are delayed or in appeals, set them aside, says Keith O. Tobin of Medorizon, an Illinois-based medical billing and collections firm. This will allow you to address those issues directly rather than just leaving them in the pipeline with the paid claims.

2. Establish a Proper Workflow Protocol. Your office should create a system for reflecting where any given claim is at any specific point, Tobin says. This way, you can check on a claim and always know where it is, as well as know what the next steps are.

3. Run Reports Periodically. Set a schedule when you’ll run reports to identify unpaid claims in the system. “Utilize both activity reports and claim date reports to ensure all claims are worked,” Tobin says. You can even configure the reports to run from the oldest date of service to the newest, or you can group them by payer to see where you’re recouping the most and the least reimbursement.

4. Stay in Touch With Attorneys for Workers’ Comp/Personal Injury Claims. When you encounter these claims, you’ll want to stay on top of the proceedings by making periodic calls to the attorneys’ offices to get updates. In addition, ensure that your personal injury claims are protected via a lien sent to the attorney, Tobin adds.

5. Know the Guidelines and Processes. If you don’t understand the specific payer guidelines, documentation requirements and reconsideration/appeals process, you will have a tough time recouping those more stubborn payments. As policies change, update the physicians in the office as well as the back office staff members, Tobin says.