We have identified some common billing pitfalls that could cause your money to be left on the table at your facility...

1. Errors in Patient Registration: Revenues are lost from not verifying insurance eligibility prior to servicing the patient and forgetting to collect co-pays.
2. Missed Reimbursable Services:  Up to 5% billable services or supplies are typically missed even though they are REIBURSABLE by the insurance carriers.
3. Old Outdated or Inappropriate Fee Schedules:  Chargemasters NEED to be set to appropriate rates with regional pricing guidlines and that you are billing for maximum reimbursement for both in- and out-of-network facilities.
4. Inappropriate or Down Coding:  A coding audit can help you to understand if you are too conservative or not documenting correctly.
5. Passive Claim Follow-up:  A proactive approach to claims is a must!  This allows you to reduce your cash conversion cycle and to catch the 2 to 3 percent of claims insurances payers typically "LOSE" instead of waiting on the EOB for documentation.
6. Poor Secondary Filing Processes: Up to 4% of your reimbursement could be left on the table due to errors or not billing secondaries.
7. Poor or Non-existent Reporting:  Key metrics MUST be reviewed on a daily basis in combination of a comprehensive monthly review of surgeon activity, costs, and ancillary services.  If you are not measuring it, you are not managing it!