We are just over a month into ICD10 and just over a month away from 2016. This is the optimal time to take a good look at your Account Receivables. You want to make sure denials and rejections have not increased due to the ICD10 codes transition. Reviewing service lines with old or untouched balances can help identify issues that can be quickly resolved before the hectic days at the first of the year.
Here are 3 ways to optimize your revenue cycle management: analyze reports, review A/R workflow processes and perform a coding audit.
1. Analyze reports
Running a denial report at lease quarterly will bring to light patterns of denials that can be prevented by staff education once the root of the issue is discovered. If the data seems a little unmanageable at first, single out your top 10 volume of billed codes initially. Often those denials will have the biggest impact on your revenue. Another way to begin is to focus on your highest-volume payers to look for trends in payer specific denials.
Enough time has now elapsed that you should be able to identify ICD10 coding related denials. This will provide you with the feedback on your processes that may need to be fine-tuned to adjust to the new code set. If you have not yet created a cheat sheet of the most common diagnoses used in your practice and their corresponding ICD-10 codes, this would be the time. The time spent in research upfront will save time later and increase productivity.
The practice management reporting found in Iridium Suite offers a wide selection of denial reports to organize data as needed.
The report criteria can be turned into a “saved” user report and scheduled to run automatically.
The results are emailed directly to any parties indicated.
2. A/R Workflow Process
I came across some alarming numbers in a recent medical billing blog. Medical practices never collect on an estimated 18% of claims. Here’s the
breakdown:
70% of claims are paid the first time they’re submitted
30% are either denied (20%) or lost or ignored (10%)
60% of those 30% are never resubmitted to payers
How does your practice keep on top of accounts receivable? You should review A/R weekly rather than monthly. Getting claims out the door is important, but if they are not getting paid it doesn’t help much. Pending, rejected and denied claims all hold valuable information that can prevent issues with the new claims being submitted.
Iridium Suite has a dedicated Account Receivables module that allows users to identify all high priority claims, like denials and overdue by the payer, with just a couple of mouse clicks.
Additionally, the Electronic Claims Queue alerts users of rejected claim messages received from the clearinghouse.
Our Proof of Timely filing report contains payer acknowledgement information that is useful in disputing a payer denying receipt of claims or with timely filing denials.
3. Coding Audit
Audit y
our coding against the medical record for accuracy and specificity on a regular basis. Evaluate the thoroughness of the documentation against the medical necessity requirements of your payers. Performing this task at least quarterly will keep it to a manageable size.
This is especially a good time to do this in respects to the ICD 10 transition. During the one-year Medicare grace period, claims will not reject solely due to unspecified ICD 10 coding.
Don’t let your ARs swallow your practice like a cartoon snowball going downhill!
Contact sales@iridumsuite.com for a free demo of the best practice management system today!
