Wow, where has the time gone? It was not my intention to start a blog and then allow so much time to elapse between postings.
We are often asked about "billing process flow" using AdvancedMD and how we add efficiencies to our practice using the tools provided in AdvancedMD.
Let me preface this blog with the fact that we use the electronic health record. In doing so, our clinicians complete the superbill/charge ticket in the electronic health record. Some of the charges are added to the superbill/charge ticket by linking templates with CPT and ICD/9 codes. Once the superbill/charge ticket is signed off in the electronic health record, the charges are posted in the practice management system. For the most part, this is a really good tool but it has some faults. For example, once the superbill is signed off, the only way to make changes is to edit the visit or reverse the charges and re-post in the practice management system. We find we do this frequently due to specific programs and rules in our state. For example, we provide programs where some of the patients charges are billed to a grant and others to the patient. Because this is very practice specific to us, I will not go into details on how we manage those nuances.
Closing the day and transmitting claims
To assure all daily tasks are completed, its important to use the "End of Day Wizard". This tool drives the process for assuring batches are closed and reconciled and visits are approved. Depending on your practice size, completing these tasks may take as little as a few minutes or as long as a couple of hours. We process approximately 120 claims per day (6 days per week) which takes approximately 1 hour to complete (less than 10 mins/day). To assure the process is as efficient as possible:
- Transmit claims daily
- Submit all claims through electronically (including all paper claims)
- review all visits and make corrections before billing (don't just approve them to get them off the list)
- If your state has specific rules that generate errors in the charge review, establish those rules in the system (i.e. we received a lot of alerts for using an ICD/9 code which is required by one of our carriers but not typical for others. We established this rule to bypass the edit on this carrier)
- review un-billed charges and make corrections to facilitate billing the next day
- Report errors back to staff and provide additional training as needed
- Report successes back to staff
Following claims transmission, its important to review the reports to assure successful transmissions. This is a great opportunity to identify problems early and therefore allow for timely corrections before billing more claims that will be denied.
Electronic Remittance Advice
Wherever possible, receive electronic remittance advice. These are easily posted using the tools available in AdvancedMD. The ERA payments will be uploaded to your key automatically and allow your staff to review prior to posting automatically or you can choose to post each claim manually from the work screen. Be sure to check your file settings for auto write-offs, allowed fee schedules etc
I do hope other ADP/AMD users will post comments/suggestions/best practices on MGMA- we can all learn so much from each other