Physicians Practice - January 2008 - (Page 54)

TECHNOLOGY patient or visit data, checking eligibility, or making coding errors — is probably occurring over and over again. Consequently, the bulk of your claims denials will all tend to be for the same reason. Find that reason and you can ﬁx it, thereby avoiding the denial in the future. Performing this sort of analysis made a big difference for Florida Heart Group, whose denial rates have dropped to about two percent, claims Bryan. In addition, the practice’s turnaround time for claims has fallen from an average of 57 days to only 28 days at present. At least some of that is due to the reports that their new system can run. “That’s a great tool, because if it’s something you know on the front end, you can either change the workﬂow or educate your staff so that things don’t even get kicked back,” she says. “It’s easy to run the reports and see what user did it and what CPT code it was attached to.” A TRIFECTA OF NEEDS Practices should also consider looking for a software package that offers all three of the functions below. • Claims Auditing — Sometimes called “scrubbing,” but what it basically means is catching mistakes before the claim ever leaves your ofﬁce. Sometimes mistakes are small ones — a required ﬁeld left blank, for example. But those little mistakes can add up to big money, says Perchick. Schneider-Maurer’s scrub rate when they ﬁrst implemented their practice management system was 90 percent. That means nine out of every 10 claims had a mistake of some sort. Using claims-auditing software, the practice reduced that scrub rate to a little under 25 percent. Still high, perhaps, but it indicates a dramatic improvement in staff performance. Perchick uses the claims-auditing software as an educational tool. “When the staff makes the mistake, whoever makes it ﬁxes it,” explains Perchick. “It’s not just the claims-scrubbing software, it’s the learning process it has when the front-end people actually use it.” Staff who gain a better understanding of what makes for a successful claim not only enter information faster, they also spend less time correcting errors. Claims-scrubbing programs can also help with common gaffs, such as transposed insurance ID numbers and misspelled patient names. Even a slight change in patient names (e.g., “Robert Jones” vs. “Robert J. Jones”) can cause the Medicare system to kick back a claim. A good scrubber will check the name or ID number against the patient’s electronic record, ﬂagging potential problems before they wreak havoc. 54 | PHYSICIANS PRACTICE | JANUARY 2008 WWW.PHYSICIANSPRACTICE.COM http://www.emdeon.com/simplify http://www.emdeon.com/simplify http://www.emdeon.com/simplify 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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