Physicians Practice - January 2008 - (Page 45)

MANAGING DENIALS Q I am looking for software that will nearly eliminate our claim denials. I started my practice four months ago and my collection ratio is only 10 percent. We have had a tremendous amount of denials, many of which have been simple office mistakes. A What billing software or management software do you use now? Make sure you are ﬁrst optimizing what you have. You also might look through some denials and chart what is causing the majority of them. Is it a need for checking patient eligibility? Poor demographic data? Poor coding? That will help you determine what problem you really need to solve. Software alone won’t solve staff errors. It’s the old “poor data in = poor data out” problem. But revenue cycle management software will really help with coding and all the payer rules and they even help with appeals. Other systems might help more with eligibility. Visit www.PhysiciansPractice.com and type “denial” into the search ﬁeld. You’ll get lots of articles and Q&As with advice and, at the bottom, vendors listed in our Buyers Guide who can help, as well as some tools you can use to improve and track your metrics. ADMITTING FROM THE OFFICE Q I have a patient disputing a 99219 charge. We saw the patient in the office but admitted him directly to the hospital. We charged a 99219 for hospital admission. However, the patient was not seen at the hospital bedside; the physician dictated the history and physical before the patient left our office. A According to CPT’s introductory notes for initial hospital care, “When the patient is admitted to the hospital as an inpatient in the course of an encounter in another site of service (e.g., physician’s ofﬁce) all evaluation and management services provided by that physician in conjunction with the admission are considered part of the initial hospital care when performed on the same date as the admission.” In other words, it does not dictate that anything needs to be done or documented in the ofﬁce or hospital, just that whatever you did can be counted toward the admit. Perhaps you should call in someone from the hospital coding ofﬁce to offer an objective opinion. WRITTEN PROTOCOLS FOR NPs Q We’ve hired a nurse practitioner for the first time, and as I was reviewing our state’s laws and policies online from the Board of Nursing, I noticed it said we must have a set of approved written protocols authorized by the physician. Considering I’m just learning about this, is there anything I can purchase that has general protocols for this purpose that I can have the physicians add to and sign off on as the NP settles in? WWW.PHYSICIANSPRACTICE.COM JANUARY 2008 | PHYSICIANS PRACTICE | 45 http://www.PhysiciansPractice.com http://www.medinotes.com http://www.medinotes.com 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

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.