Optimizing The Revenue Cycle 5 of 12: Documentation

Posted by Crystal L. Miner, MBA-HSA, FACMPE on Jan 9, 2019 7:52:00 AM

We all know the phrase “If it’s not documented, it didn’t happen.” The question is, “how do you document what happened, accurately, in a confusing EHR, in a way that will meet requirements and allow you to get paid?” Not an easy thing to answer but there are a number of tools and resources for providers and administrators to help. Tools range from the EHR to the billing team (internal/external), and utilizing external resources. Administrators must help their providers be knowledgeable of the tools available and the guidelines required.

 

Accurate documentation is a key to appropriate coding and charge entry which are major parts of the revenue cycle. Administrators should assure that their providers know how to accurately document what happens in their encounters with patients. Today this revolves around a provider’s use of the EHR, as 85% of office-based providers use one. Providers should not be focused on insurance/payer requirements. This is the prerogative of the billing department. Instead, knowing and following coding and documentation guidelines should be the priority. This requires constant training and communication between a clinic’s billing team (internal or external) and providers. 

 

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Topics: revenue cycle management, Medical Practice Improvement, check-in

Optimizing The Revenue Cycle 4 of 12: Check In/ Check Out

Posted by Crystal L. Miner, MBA-HSA, FACMPE on Jan 3, 2019 7:46:00 AM

When checking in at a hotel, what makes it so painless and easy? The fact you know when to show up and what is expected of you, probably. You told the hotel you would be there on the 12th, and they have a regular check-in time of after 3 pm which works for your schedule. Upon arrival, you tell them your name and give them your photo ID and credit card. You know this is so that they can verify your identity and get paid for the room you are about to use. They may ask to confirm how many nights you are staying, just to be sure, but that is all. Then you sign the paperwork saying you won’t destroy their property and that you authorize the hotel to charge your card, they hand over the room key and off you go! 

 

Obviously, checking in at a medical clinic will rarely be as smooth as checking in at a hotel, but we could get close. In addition, our collections at the front desk should be just as good. The key is to set expectations for our customers. People coming to see their doctor expect to pay everywhere else they go – why not at the doctor’s office? Times have changed from when insurance companies “covered everything.” The current trend is now for them to cover “after deductible” instead. If we can educate and support patients with this new expectation, we will see smoother check-ins and an optimized revenue cycle.

 

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Topics: revenue cycle management, Medical Practice Improvement, check-in

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