Maintain Your Practice's Profitability
Remembering coding guidelines and carrier discretions is hard enough, but adding that on top of trying to provide quality care during your hectic day often wreaks havoc on even the best of practices. The trick to success is organization and simplification. Some simple tips and organization recommendations can help your practice glide past these barriers and remain profitable.
1. Use Advanced Beneficiary Notices (ABNs)
If you provide any service in your practice that has a frequency limit or a National/Local Coverage Determination, you should know the importance of ABNs. Many practices struggle to identify who in the office is responsible for this form. The answer is always the same-it is the responsibility of the person providing the service. This doesn't mean the job cannot be made simple for you. Although ABN forms may not be altered, they can be customized. Pre-populate the form with some information for patient ease-of-use. Start a binder and include ABN forms with the names of procedures, prices and reason(s) why the service might be denied. Place a binder in each exam room, or in a central area.
2. Keep E/M Scorecards Nearby
Place E/M scorecards on the backs of cabinets or doors in each exam room. It is sometimes impossible to remember all the caveats of E/M coding during your busy patient day. A "cheat sheet" simplifies the process, allowing you to have a reference readily available during the patient encounter.
3. Don't Limit Your Diagnosis Codes
Don't limit yourself to your "top 20 diagnosis codes" by only putting a few diagnosis codes on your encounter forms. Instead, handwrite your diagnosis codes so that your staff can assign the appropriate code. Providing only check boxes for a limited number of diagnosis codes leads to incorrect utilization and denials.
4. Simplify Incident-to-Billing
If you are utilizing non-physician providers (NPPs) in your practice, you know how overwhelming it is to keep up with whose billing number the service was provided under. Add a spot on your encounter form for the provider to check or indicate what numbers should be used for billing purposes. This will ensure you're capturing the revenue and not leaving money on the table, while also improving your compliance.
5. Only Take Coding Advice From Reputable Sources
If someone is trying to sell you on something that will increase your revenue substantially, chances are that it's a scam or the claim is inflated. This goes for electronic medical records (EMRs) as well. EMRs have value, but do not be deceived by claims that any EMR can code for you-I assure you that they cannot. EMRs cannot determine medical decision making, or the difference between a new and established problem, for instance. They also cannot calculate free-hand text, which could actually cost you to lose valuable revenue.
Remember to do your homework and to develop your policies to help you along the way. With good communication and clarification, your practice can continue to succeed. It is always best to review your coding practices at least quarterly to monitor any changes to insure compliance within your practice. Monitor your accounts receivable on a monthly basis, to make sure you are not suffering unnoticed losses.