Physicians Practice - January 2008 - (Page 31)

you fall in terms of your colleagues,” says Breeze. “If you prescribe more expensive prescriptions, maybe you can explore a different formulary. It’s not only the insurance companies who need to save money.” Look at every operational aspect of your practice, especially your staff. “Getting paid fairly is important and you should do everything in your power to do so, but there is also pressure on you to make sure you don’t have employees who aren’t working the way they should,” says Breeze. Code and bill properly. This is undoubtedly one of the most challenging aspects of the whole process of payment by insurance companies. “Even when a practice has a good coder, it’s difﬁcult,” says Cobuzzi. “It’s not an exact science.” Cobuzzi also points out that billers are not necessarily coders, or vice versa. Billers may not be certiﬁed in coding. This is a concern, she says, because such billers could have critical gaps in their knowledge. Worse, they may not be unaware of current protocols, which morph regularly. “A practice has ‘Darla,’ and she’s ‘wonderful,’” she says. “But Darla’s been doing the same thing for 15 years.” Make sure someone in your practice is coding-certiﬁed. The American Academy of Professional Coders offers certiﬁcation and continuing education — well worth the time and effort, not only because you’ll know how to code higher and collect more, but also because “you’re protecting your practice,” Cobuzzi says. “If you’re audited, you can show that you spent that extra effort. You can show you’re trying to do the right thing.” As for billing, you certainly want to send out clean, complete claims. As complicated as claims are these days, claims scrubber software has pretty much become de rigueur. Ramp up your patient collections. With Simply put, collect while your patient is standing in front of you. Physicians should count on a 17 percent to 30 percent loss chasing patients’ money if they don’t collect up front, says Madden. “Obviously, if they’re chasing money it costs them.” Breeze also notes that “it has become truly mandatory to know your allowables. That requires some work ahead of time. You need to make sure the patient actually has the beneﬁts he says he has.” If a patient truly has a ﬁnancial difﬁculty, you can set up a payment plan. “In general, people want to pay for their services; they’re not trying to shirk,” says Breeze. Regardless, the more time you let go by, sending statement after statement, the more likely you’ll never see any of that money. So make it easier on everyone by considering these solutions: • Use the ACH debit system for patient accounts on a payment plan. “We ALLOWABLES FOR NON-E&M CODES CPT CODE 90465 90466 90471 90472 90633 90658 90669 90732 90772 90801 90804 90805 90806 90807 90862 92083 92135 92557 92567 93000 93010 93015 93016 93307 93320 93325 93880 94010 94060 94640 94664 95004 95024 95044 95115 95117 95165 95819 95860 95861 95900 95903 95904 96110 97110 98925 99173 99222 99223 99232 99233 99238 99239 99254 99291 99391 99392 99393 99394 99395 99396 99431 AVERAGE REIMBURSEMENT $17.32 $13.31 $15.19 $11.71 $40.74 $18.02 $71.88 $28.72 $17.25 $222.72 $130.00 $107.39 $143.50 $144.36 $75.96 $75.31 $50.61 $56.67 $22.95 $33.42 $17.27 $221.38 $30.84 $213.16 $119.16 $176.72 $204.33 $139.07 $65.20 $19.19 $10.40 $10.40 $6.47 $174.86 $14.43 $2,901.60 $32.06 $181.00 $108.11 $119.60 $76.29 $74.38 $63.02 $17.79 $46.00 $28.49 $10.70 $110.00 $182.67 $80.46 $79.55 $130.20 $110.00 $166.92 $260.49 $81.31 $85.40 $90.99 $91.25 $107.13 $124.02 $118.47 ﬁnd they actually like it,” Breeze says. “Or we use their credit card. … It takes it out of their hands.” And into yours. • Point patients toward healthcarespeciﬁc ﬁnancing options, such as CareCredit. This is similar to a regular consumer credit card, but with ﬂexible no- or low-interest offerings to leverage a patient’s out-of-pocket costs. Once obtained, a patient can use his CareCredit card repeatedly, although he should be highly cognizant of honoring the terms, as a late payment could result in a jacked-up interest rate or some other penalty. • Verify, adjudicate, and collect all in one place. Check out InstaMed, a Web- more of the cost of healthcare resting on patients’ shoulders, you’ll want to shore up your collections practices. WWW.PHYSICIANSPRACTICE.COM based outﬁt that offers real-time insurance veriﬁcation to 430 payers, real-time claims adjudication, and electronic payment from both patients and payers. Bill Marvin, president of InstaMed, says the service brings the worlds of banking and healthcare costs together. It’s fully HIPAA-compliant, highly secure, and fast. “When you do an eligibility transaction, you’re going to get an answer 99 percent of the JANUARY 2008 | PHYSICIANS PRACTICE | 31 http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - January 2008

Physicians Practice - January 2008 Contents The Bigger Picture: Fixing Medicaid Letters Physicians Practice Pearls: You Can Teach an Old Dog New Tricks Noteworthy Cover Story: Fee Schedule Survey: 2007 Results Adding Ancillaries: Bucking the Practice Ask the Experts Idealab: 'How I Got Over My EMR Excuses' Technology: Don't Be Denied The Tech Doctor: Blessing or Curse? The Administrator's Desk: Learning From the Best Coding Career: To Partner, or Not? Management: Controlling Your Inventory Human Resources: How to Fire an Enployee Finance: Beyond Reimbursment - How to Fix Your Mix Classifieds Advertiser Index

Physicians Practice - January 2008

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