#1. Check your denialsDenials come in at two levels: the clearing house and from the insurance company (on the EOBs). Now is the time to go over the denials that may be coming in at either level and fix them at the root. The daily billing department actions would dictate that you handle the denials and resubmit, but what I am talking about here and looking for the TYPE of denials you are getting and trace them back to the root cause.
For example: Frequent coverage related denials usually indicated a problem at the insurance verification level OR it is a LCD related issue.
Another example: Too many demographic denials means someone is overwhelmed or not paying attention. Now would be the time to trace that down and assist that employee to do better.
#2. Review your coding and LCDsAs mentioned previously, not knowing your insurance companies LCD can result in a lot of uncovered services. Now is a good time to review the LCDs again and pass them onto the staff to review as well. Note any changes for the new year.
Same goes for coding, make any needed changes to fee slips, etc that may be applicable for the coming year.
#3. Tackle your A/R reportWould you be surprised if I told you I often encounter doctors who don't even want to look at their Accounts Receivable report? It's true. Sometimes the fear of just how bad it is can stop us from wanting to look. Like, when you don't check the mail for days because you know all you'll find is bills.
However, as uncomfortable as it might be, now is the time to take a look and make a plan to get it tackled in the near year.
Some things to keep in mind:
In summaryThe new year is a great time for a fresh start. Taking on the above three points can make a huge difference in getting your office off to the right start in 2019!
Jessica Rose Greenwood
Jessica is the owner of JMK Billing, a Billing Specialist and expert in office management