Urology Coding Alert

Our experts show you how 4 billing reports can help jump-start collections You review your EOBs each month to pinpoint the causes of your denials, so you've done all you can to minimize future denials, right? Not so fast--the best medical office managers know you can't stop there. Monthly billing reports should be the second line of attack in denial management.

"Running reports and scrutinizing EOBs are the best ways to track denials," says Susan Vogelberger, CPC, CPC-H, CMBS, owner and president of Healthcare Consulting & Coding Education LLC (HCCE) in Boardman, Ohio. 

"Depending on the practice volume and personnel, bi-weekly and even weekly reports may be the way to go," Vogelberger says. The more often you run your reports, the faster you can catch carrier problems and correct them. "Sometimes a phone call to the insurer can correct the problem if it's something minor," Vogelberger says. Get to Know 4 Monthly Reports 1. Aged trial balance by insurer. Most urology Coders are already familiar with an aged trial balance report (also known as an A/R aging summary) as a way to identify past-due accounts and unpaid claims.

But an aged trial balance is also a great place to start identifying denial trends that can indicate a billing problem in your office, says Anne Rowland, a billing consultant who works with three urology practices in Dallas.

Example: One of your physicians lets his Medicare credentialing expire. If you run an aged trial balance by insurer, you will start seeing a problem in the percentage of payments coming in from Medicare.

The total amounts in your 30-, 60- and 90-day unpaid-claims file will start to grow as aging continues. Once you discover this trend, you'll be able to uncover the root of the problem you're facing. 2. 120-day A/R report. When you run your monthly aged trial balance, you should also run a report of just the accounts that are 120 days or greater past due.

Go through this report and make sure you've worked on each account recently and that you already know the cause of the hold-up. Many times you will find a rogue account or two that has been overlooked and may represent a denied claim that you should appeal. 

Note: You could also do the same review of all accounts at 30, 45, 60 or 90 days.
 
3. Procedure analysis report. This report should include charges, payments and amounts that patients still owe on your most frequently billed procedures. If your office faces denials because you report a particular code inappropriately, this report will highlight the problem.

Example: If your practice still reports G0356 (Hormonal antineoplastic) for Lupron injections instead of the more current code 96402 (Chemotherapy administration, subcutaneous or intramuscular; hormonal [...]