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The EMR Billing Specialists

4 Thoughts on conducting a successful RCM Audits [Infographic]

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Regular RCM audits have become an absolute necessity to run a successful and compliant medical practice. This infographic explains in detail the four tips shared by healthcare administrative and revenue cycle expert Karen Bowden, to conduct successful RCM audits. Her thoughts were recently published in Becker’s Hospital Review.

Successful RCM Audits

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Medical practices should conduct regular RCM audits to mitigate financial risks in the future. Frequent audits helps in eliminating redundant processes and adopting best practices to achieve optimal outcomes. Please share this infographic if you found it useful and help us reach more people.

Efficient Error Reporting Systems lead to Healthier Practices

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 Be the one to take a call !

To error is human, but, to report it took super human efforts, until recently. A recent study by the Perelman school of medicine at the University of Pennsylvania, confirms that reporting errors leads to a safer medical practice.

As frontline healthcare workers, physicians fear, losing credibility or possible intimidation. And, are dubbed as, “reluctant partners” when it comes to reporting medical errors. This finding is hoped to open the doors for more open communication within a medical practice.

I’d Rather tell My Friend !

Error reporting systems in most healthcare facilities frustrate and limit physicians. Most hospitals do not have a structured reporting system, for physicians to report errors. Though all healthcare facilities have a reporting system in place, they are hardly what doctors hope for.

Not just a Fancy Asset…

The reason why most reporting systems fail is that they’re, like that vase of pansies in the reception, just a fancy asset in most practices. They don’t guarantee privacy and reporting anonymously is not an option at all. This lack of privacy can in effect harm patients and the security of patient data.

Speaking up !

As the awareness about the need for efficient reporting systems increases, it is high time that hospitals set up a system that their staff are, comfortable with. Building baseline data on errors can lead to higher efficiency and healthier patients.

Every physician setting up a new practice should, apart from concentrating on low cost insurance credentialing services , recruiting and payrolls, also set up an efficient reporting system !

Is your Practice Safe Against Fraud and Abuse Penalties?

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You hear it everyday, practices being penalized, physicians being brought to book. But like cancer it is something that happens to somebody else, unless it hits you out of the blue.

Every physician strives to work in an ethical, profitable and secure practice. With Medicare coming down heavily on physicians with improper records, it is high time physicians took a closer look at what they’re billing for.

If it is not in your Records, it never Happened !

And that is why errorless medical documentation is absolutely necessary. The AMA and other regulatory bodies stress on the importance of having clear documentation for every claim submitted. More often than not physicians’ frantically search and put together documents to substantiate their claims, after a rejection slip from the insurer. It is good practice to have the necessary documents supporting your claim prior to filing it.

Small Errors can lead to Big Repercussions.

It is disheartening that most medical practitioners, who are penalized for fraud and abuse, are victims of minor errors. The most common mistake is upcoding. Not knowing how to assign E/M codes for subsequent visits or misuse of modifier – 25 are what most practices are guilty of.

Report Over-Payments inside of 2 months…

Just spotted a billing error? Report it and return the overpaid amount to Medicare and Medicaid funds. Practices who fail to return overpayments within sixty days will be penalized under the false claims act. Regular audits and close introspection of billing reports can help practices to notice and return overpayments, before it’s too late.

The Ball is in the Doctor’s Court !

Though being responsible for so many aspects of a medical practice can be burdensome it is also highly rewarding. Physicians need to juggle a lot many tasks. But the fact that the ball is always in the physicians court, and there is a chance to correct flaws is reason enough to smile.

Physicians need to be more proactive and involved in their billing cycle and the latest guidelines, are a remainder to stay in the loop !

Are you Receiving Billing Reports on Time?

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If your answer is no, here is why you should demand for one. Getting involved in the business side of medicine can be a nightmare, if you’re a busy doctor shuttling appointments. But going by the recent unhealthy trend of doctors being in the limelight for faulty billing, staying unaware of the financial state of your practice can be a costly mistake.

 On your Feet all day long but not Earning Enough…

Your appointment scheduling are choc-a-bloc and there is hardly enough time to breathe or do the laundry, but that just one indicator that you are running a successful practice. The other more important factor being how much you are earn at the end of the day. Entrusting the entire billing tasks to your in house biller or vendor can be prove to be a risky proposition in the long run.

All Fingers Point to the Physician !

It is unfair and crazy but every time there is a blooper it is the physician who is held at gunpoint. More often than not it is not planned embezzlement but simple oversights that can put your practice in the hot water.

Get that Financial Reporting System in Place !

The major hurdle for doctors and billers in setting up a reporting system is the lack of knowledge in implementing one. To start off create a dashboard of your key metrics. It can be revised, later on, to accommodate newer benchmarks and performance indicators set by you.

Here is what a Basic Checklist should consist of…

  • Ar reports that mention clearly the number of days in AR.
  • Insurance payment turnaround report.
  • A list of the contracted allowable for payment by insurers.
  • Monthly production and collection list.
  • The net collections of your practice.

Get it off the Ground, Today ! 

Demand for a financial report from your medical billing company or in-house biller to put your practice on the right track. It will help you analyze the financial performance of your practice, curb unhealthy trends, and finally know what your biller does !