5 Provider Tips to Maintain Practice Profitability

You went into medicine with the grand idea that you would spend your days helping people, but the reality is much of your time is spent on the business of healthcare. Here are five tips that will make that part of your job a little more productive:

1. Use Advanced Beneficiary Notices (ABNs). The ABN is a standard form providers can use to inform a patient that Medicare may deny coverage for a recommended or desired item or service. It explains why Medicare may deny coverage, and provides a cost estimate. Finally, an ABN notifies the patient of his or her responsibility to pay for the non-covered item or service. In many cases, you cannot seek payment from the patient for unpaid Medicare services if you do not properly issue an ABN.

2. Keep evaluation and management (E/M) scorecards nearby, such as on the back of cabinets or doors in each exam room. It can be difficult to remember all the caveats of E/M coding. A “cheat sheet” simplifies the process, allowing the provider to have a reference readily available during the patient encounter and while documenting the patient’s visit.

3. Don’t limit yourself to the “top 20 diagnoses” listed on your encounter forms. Handwrite your diagnosis so staff can assign the most specific, appropriate code. Providing only check boxes for a limited number of diagnosis codes leads to incorrect utilization and denials, and may not accurately report the patient’s condition.

4. Simplify incident-to billing. If you have non-physician providers in your practice, it’s important to track under whose billing number a service is provided. Add an area on your encounter form for the provider to check or indicate what number should be used for billing. This will ensure that you’re not leaving money on the table, while also improving your compliance.

5. Keep current. Review your coding practices at least quarterly to ensure compliance with ever-changing guidelines. Monitor your accounts receivable every month to make sure you are not experiencing unnoticed losses.

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John Verhovshek

John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.
John Verhovshek

About Has 402 Posts

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

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