Normally when I write a quick tips list, I write it so it can be read in 2 minutes. However, this is health care, and a lot of one liners just won’t get it done. So, this time around it’s 3 minutes that this should take, with not a lot of details. If there are any questions… that’s what this type of post is supposed to generate.

192-365 The New Queen Elizabeth Hospital
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1. Correcting your top 3 errors will eliminate 50% of all errors. The same goes for denial codes. Correcting your top 10 usually takes care of 80% for each as well.

2. Working your 20 highest outstanding claims over 45 days old weekly can bring a nice boost in cash and reducing your receivables. This doesn’t include self pay; hopefully those were addressed in some way before they entered receivables.

3. If you have fewer than 7 billing personnel, each person should be taught how to do everything. If you have more than 20 then there should always be at least 5 people who work on inpatient claims.

4. Every member of the patient accounting department should know how to read a CPT-4 manual the proper way. I’ve met so many people who didn’t realize that if there’s a semicolon after a description it means the next numbers in line use the beginning and then default.

5. All patient accounting staff that works any insurance claims needs to be taught proper investigative phone skills so they know how to ask follow up questions to responses they’re given when needed. This eliminates multiple phone calls and helps them get a better working relationship with those insurance companies.

6. Whether they report to the same director or not, at least twice a year patient accounting staff and registration staff should have meetings with each other to understand each other’s pressure and learn why things might be going wrong. Registration needs to know why good information is crucial and patient accounting needs to understand how easy it can be to make mistakes.

7. Patient accounting staff needs to understand the meaning of all denials because they need to know who to go to depending on what the denial is. All denials do NOT go to medical records, which is often the belief of a lot of patient accounting personnel.

8. The director of patient accounting needs to have a good working relationship with the director of every ancillary department, HIM, Purchasing, IT, Finance and Corporate Compliance. This means getting out of the office and pressing the flesh. You can’t correct everything by yourself.

9. Procedure manuals are the only proof that management has offered training and a great resource for employees to get most of their questions answered. As procedures change, change the manual.

10. Work those credit balance reports, and if people are owed money send it back to them. If the balances can be applied to other claims, do it. It’s the ethical thing to do.
 

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