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Top Culprits that Slow Revenue
By Sally Eggleston, MBA, RT(T)

Many facilities and physicians do not realize the importance of ensuring that all demographic and disease classification is complete and accurate prior to submission of claims. Chances are whether you currently perform in-house billing or outsource, as soon as this pertinent information and the initial charges are received, claims are out the door. Any additions and/or changes to this vital information will lead to a delay in receipts, which then results in sluggish revenue.

While most successful business adheres to the lesson that the first person to interact and work with their clients is one of the most important, medical providers have been slow to learn this lesson in regard to their patients. That initial interaction with patients and gathering of current insurance and demographic information is vital to any practice. Filing claims to the incorrect payor or with any incorrect patient information results in denied claims and no cash flow.

Too many times we see that there is an update to the diagnosis code in the EMR after claims have been submitted. This would then require a corrected claim which inevitably results in payments being detained and this is assuming that the updated information is processed. Physicians must take responsibility for the correct ICD-9 coding to ensure claims are accurate and payment is received. With the implementation of ICD-10, a concentrated effort to learn and understand diagnosis coding should be a priority for every physician and facility.

RC Billing strives to educate all physicians and associated clinical staff so that all realize the importance of these nuances. A bit of forethought can go a long way in ensuring compliance and cash flow. For more information regarding our services, please contact Sally Eggleston at sally@rcbilling.com.

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