Insurance Issues
Reimbursement Analysis…. How it can benefit your practice?
How well does your practice keep track of the amount of money that they are writing off to insurance companies?
Are you tracking the amounts and doing occasional spot-checking for the compliance accuracy of the insurance contracts for your practice?
These questions are not easy to answer. To be truly on top of the billing and write off “situation” requires much organization, dedication and review. Here are a few hints to help with this process.
- Development of a spreadsheet that gives the billing staff the correct amount to expect for the services offered in the practice
- Once the spreadsheet is complete, it is time to educate the billing personnel what is expected of them in monitoring compliance
- After the billers have begun using this spreadsheet, it will be important to review the data and process on an annual basis
Below is an example of a spreadsheet we developed for our clients. We find this to be an excellent tool for an office, to manage and be on top of their own reimbursements.
Procedure
|
Description
|
Practice
Fee |
Medicare |
Inc. Co.
A |
Ins Co. B |
Ins. Co. C |
99212 |
Office Visit
Level 2 |
$40.00 |
$ 35.95 |
$ 22.25 |
$ 18.35 |
$ 19.25 |
99213 |
Office Visit Level 3 |
75.00 |
59.59 |
22.85 |
24.13 |
23.15 |
17000 |
Destruction |
105.00 |
61.82 |
66.85 |
59.42 |
66.00 |
93000 |
EKG |
75.00 |
20.17 |
19.50 |
17.62 |
29.52 |
O’Sullivan Consulting Group can assist providers in dealing with some of the additional demands of managed care plans and credentialing. For further assistance please contact Machelle at 330-723-2111 or machelle@osullivanconsult.com.
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