Some of the imminent changes in 2013, which can affect billing and collections, are –
- New updates in CPS and HCPCS Level II codes, Place-of-service coding errors
- Noncompliance with Assignment rules and Excessive billing of beneficiaries to be penalized
- Inappropriate payments in 2010 by Medicare to be appropriated in 2013
- Questionable billing in electro-diagnostic testing to be introduced
- Part B payments for Glycated Hemoglobin A1C tests to be updated
- Claims processing errors to be corrected with regards to the Medicare payments for Part B claims with G Modifiers
- Use of Modifiers during Global Surgery Period to be evaluated and managed
- Updating your billing system with coding changes at a regular interval. CPS and HCPCS coding changes can be readily monitored by keeping in touch with medical publications and coding manuals
- Educating your staff regarding regulatory changes and the expected impact of the same on your billing and collection practices
- Checking with insurance provider for pre-authorization and medical coverage details at the registration stage itself, in order to avoid claim denial later on
- Managing claim filing process and revenue cycle as per the requirements of insurers and reimbursing bodies
- Monitoring outgoing information and incoming requests or notifications from insurers regarding claim settlement, disputes, document requirements and regulatory changes
- Install a denial management system in place to track the reasons and trends in denied claims
- Resubmit corrected claims or file appeal for denied claims with in a turnaround time of 48 hours or less. Ensure review of medical codes, document requirements and grounds of appeal before taking any action
- Streamlining revenue and accounts to absorb the penalties and costs incurred by audit actions
- Adhere to all regulations pertaining to laboratory tests and electro-diagnostic tests. With decreased reimbursements and specific guidelines for conducting tests, even a minute oversight can prove to be expensive for your practice