Wiki Process for reviewing accounts?

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HangarPilot

HangarPilot

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You know how things slip through the cracks? Well, we recently did a systematic "housekeeping" effort to address all those things. Credits on accounts that needed to be refunded, writing off claims that were denied 4 years ago :eek:, posting payments that were "unposted" (taken in by the staff and applied to the patient account but to applied to the claim), and various other aging efforts.

I've been researching and wrestling for months on how to move forward. Does anyone have a "process" they would be willing to share on how to stay on top of these things?

For example, take credits on accounts. Some patients want the credit left on account to use at the next visit. If I decide I'm going to review credits monthly, then every month I waste time rehashing all the existing credits looking to see if there are any new ones. Which makes me wonder if it would be better to wait and do "major housekeeping" like this once a year or something?

Any suggestions on finding a balance between "staying on top of these things" versus "spending too much time looking at the same tired claims/accounts over and over"?
Thanks!
 
What software are you using? The answers you receive are probably going to be pretty software specific. They also may be size of practice specific actually.

In a small practice, I used rolling reports. I would run the same credit report every three months for a specific time frame. Our software though did not allow for tracking of patients who wanted to keep their credits on file for future visits, so patients would be informed that a refund was available to them and we required an address to send it back to. Does your software have some notation feature that would make it easy to pull/ignore patients from your reports? If it doesn't, would it be feasible to pull your patient's into an Excel document and then add a column for "last reviewed" and "use for future appt"?

For timely, working through outstanding AR on a regular basis should prevent that from happening. If it doesn't, then a rolling report here could benefit you as well. Every month pull dates of service that are two years or older, and then have other reports for 90-180 days outstanding and 181 days and over outstanding.

I hope there are others who can chime in and offer some assistance!
 
This always seems to be something easily put on the back burner in any office I have worked in. Of course getting the data info, charges and payments in seems to be the most important and upkeep falls by the wayside.
As most of our workers are busy with the daily and more important tasks, we have to break down our reports to hand off to work on during those low times. Most times a report is run and can take up to two months to work.
Our PM system does not differentiate for credits on accounts for patients with future visits. We run separate reports of: insurance credits, patient credits and monthly aging.
The monthly aging is worked in sections per insurance carrier as some of the employees work specifically with Medicare and some with UHC, etc. They typically pick the high dollar surgery claims to work first and then trickle down from there. They will verify with the carrier that the claim was received and processed, then work on the claims that need appeals or adjustments.
The credit reports are worked to determine the carrier credits and who to refund in cases of COB problems. Then the checks are submitted with the correct insurance refund forms.
Working the patient credits requires a review of the charges to make sure proper adjustments were made, then verify on the schedule if the patient has a follow up appointment as some of our appointments can be 3-6 months out. We will not refund if there is an outstanding insurance charge or an upcoming appointment.
These reports are worked by many employees throughout the year as they find time. Always wish we had one person who just did reports :)
Not sure if this is helpful or just confirmation that we all fall behind in this area...
~Jennifer Sanders, CPC, CPB, CPC-I, Fellow
 
Thank you both for the advice!

I'm a huge computer nerd and I guess just a little perplexed why this isn't easier to manage. Even though I've manage to create new status codes and such, it doesn't help much because we still end up having to revisit old claims/credits. By the time you get to the follow-up to the follow-up to the follow-up you start spending more and more time just trying to refresh your memory on what the issue was from 6 months ago. ;)

Guess I will take your advice and go old-school with the reports/lists/spreadsheets and create my own "tickler" system. That means I have an excuse to create some new spreadsheets - how cool is that (did I mention I'm a real nerd?)! :D

Thanks again.
 
Does your PM system not allow for notes?

If not, then make sure to add some columns to your Excel sheet or consider creating an Access database. You can then save a history for each medical record number and then DOS, so back and review your old notes if you find yourself working it multiple times a year.
 
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