One of the most important things in billing is to create and follow a very structured plan that can be measured each step of the way. Remember, if it cannot be measured and monitored it cannot be improved! One key element of this plan must be how to consistently and reliable create clean claims.
Clean claim submission can reduce average days in AR to less than 45 days
The leading medical billing services utilize scrubbers that ensure your claims are clean before they are submitted to payers. These scrubs accelerate the speed of collections by avoiding denials and delays. They also increase collections by minimizing the volume of "re-work" and allowing billing staff to focus their efforts on pursuing true collections improvement opportunities and not simply resubmitting claims that should have been paid the first time. As a result of these scrubbers, over 90% of claims submitted are paid upon first submission. These "scrubbers" include:
- Basic mechanical scrubber. This scrubber assures that all claim fields have been properly filled with formatted data (social security number with 9 digits, date of birth etc), the NPI is in a proper field, there is a referring physician if needed, etc.
- Scrubber that checks coding, bundling, and procedure information versus local Medicare and CCI rules. This scrub assures better coding, identifies overlooked procedures or codes.
These scrubbers will lead to a marked improvement versus a billing process with no scrubbing; they are, however, not a complete scrubbing solution. A full solution requires a scrubber that can have a customized rule set that takes the knowledge of the billing company or medical practices and codifies it so that it can be applied to every claim before submission. This scrubber is:
- Customizable Rule Scrubber that applies the learnings from each denied claim to all future claims. This allows the rules to stay in step with the payers ever changing adjudication rules. Such scrubbers are the hallmark of the best medical billing services.
Utilizing all of the scrubbers outlined in this article will dramatically lower days in AR and allow the billing staff to properly purse any issues that remain. In today's medical billing environment, use of these scrubbers is truly mandatory.
Copyright 2008 Carl Mays II - 15359
Clean claim submission can reduce average days in AR to less than 45 days
The leading medical billing services utilize scrubbers that ensure your claims are clean before they are submitted to payers. These scrubs accelerate the speed of collections by avoiding denials and delays. They also increase collections by minimizing the volume of "re-work" and allowing billing staff to focus their efforts on pursuing true collections improvement opportunities and not simply resubmitting claims that should have been paid the first time. As a result of these scrubbers, over 90% of claims submitted are paid upon first submission. These "scrubbers" include:
- Basic mechanical scrubber. This scrubber assures that all claim fields have been properly filled with formatted data (social security number with 9 digits, date of birth etc), the NPI is in a proper field, there is a referring physician if needed, etc.
- Scrubber that checks coding, bundling, and procedure information versus local Medicare and CCI rules. This scrub assures better coding, identifies overlooked procedures or codes.
These scrubbers will lead to a marked improvement versus a billing process with no scrubbing; they are, however, not a complete scrubbing solution. A full solution requires a scrubber that can have a customized rule set that takes the knowledge of the billing company or medical practices and codifies it so that it can be applied to every claim before submission. This scrubber is:
- Customizable Rule Scrubber that applies the learnings from each denied claim to all future claims. This allows the rules to stay in step with the payers ever changing adjudication rules. Such scrubbers are the hallmark of the best medical billing services.
Utilizing all of the scrubbers outlined in this article will dramatically lower days in AR and allow the billing staff to properly purse any issues that remain. In today's medical billing environment, use of these scrubbers is truly mandatory.
Copyright 2008 Carl Mays II - 15359
About the Author:
Carl Mays II, CEO of ClaimCare Medical Billing Services, has spent over 14 years enhancing the financial performance of his clients. To read more about selecting Healthcare Billing Services subscribe to Carl's blog
