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5 Ways Your Front Desk Can Maximize Profits

Written by: Allie Shook on Monday, August 14, 2017 Posted in: Outpatient Rehab

One of the best ways to ensure your practice remains profitable is to collect every dollar you are owed for the services you provide. Obviously, billing is a key component, and ensuring accurate billing and collections starts at the front desk because the tasks and processes initiated there have very real implications throughout the entire revenue cycle management process.

The following guidelines can help your front desk staff do their part from the beginning to help maximize profits in the end.

1. Verify Eligibility and Benefits

This is the most critical step in the process, so, ideally, it should be done at every visit. However, if that isn’t practical for your practice, be sure that your team verifies eligibility and benefits at least with every new patient and at the beginning of a new calendar or plan year for active patients. This includes both primary and secondary insurances as applicable. About 15% of claims have to be worked after the fact to get paid, and bad insurance information is the most common source of denials. That’s why it’s so important to verify and reverify as necessary.

  • Do not skip this step. If you choose to, you’re most likely to learn of issues with eligibility when your claims are denied.
  • Identify specifically who the billing staff needs to bill. It’s not always clear cut, so it is important to identify who needs to be billed, especially when patients have both primary and secondary insurance.
  • Develop a robust financial policy to ensure you collect every dollar you have earned, and ensure that all patients sign forms indicating they understand the policy. The policy should state that patients are responsible for any portion not paid by insurance, and include a statement that explains that attorney fees and other collections costs—should their accounts be referred for collection—will also be their responsibility. In addition, include language allowing you to contact them on their cell numbers for collections.

2. Check and Double-Check Patient Information for Accuracy

All data entry must be accurate and should match what’s on patient insurance cards. Nicknames or other internally used names are irrelevant. The name on the claim must match insurance cards exactly.

  • Know the difference between Medicare and a Medicare-replacement plan because this affects where claims are billed. This is a common mistake, so your staff must be proactive in understanding the difference and take care that they are queuing claims correctly so that each claim goes to the correct payer the first time.

3. Know Each Patient’s Authorizations Requirements and Visit Limitations

Generally, with cases of workers’ comp and MVA/personal injury, preauthorization is required. But it’s becoming more common that commercial payers and third-party administrators require preauthorization as well. This is a common reason that claims have to be worked after the fact.

  • Find out if preauthorization is required.
  • Determine if the number of visits is limited. If visits are limited, you have to know the amount of therapy hours that remain, and you have to keep track of the care you provide. This way, you either stay within the limits or use the correct modifier if you have to exceed the Medicare cap.
  • Choose an EHR that can track authorizations and visit limitations for you, so you don’t waste time providing therapy services for which you may not be paid.

4. Time-of-service collections

Collecting your patients’ copays, deductibles, and other out-of-pocket expenses prior to service is critical. If you don’t collect prior to service, you may never be able to collect at all.

  • Copays are fixed amounts and are easy to identify.
  • Unmet deductibles also need to be determined and collected up front
  • Coinsurance should also be collected, but it’s a bit tricky because the amount varies based on the therapy you provided that day and how much that payer allows for that therapy.
  • Maintain credit card information on file for outstanding balances, but be sure the data is secured. To be compliant with payment card industry (PCI) standards, you need to be able to know when a breach occurs. If a breach takes place, you need to know who was affected. There’s a lot of rigor that goes into keeping credit card information secure and in compliance with PCI requirements, so it’s probably wise to work with an organization that can help you or work with a third-party vendor that provides credit card processing. Don’t do it on your own. It’s too risky.

5. Timely charge entry

Patient charts must be completed prior to charge entry because the data flows from your EHR to the billing software.

  • Complete your documentation the same day, if at all possible. This applies to CPT codes as well as finalizing and signing your notes. MediLinks, for example, allows you to document your charges in real time as you’re interacting with patients, so you don’t have to try to input them after the fact. The quicker you get your charges entered, the quicker the billing goes out, and the quicker you get paid.
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