Verify the date of the last office visit for each patient. If it's been over three years, code it as a new office visit. "You can charge a new office visit and raise your reimbursement by 18 percent for that visit," says Judy Campodonico, director of operations with MRG Management Services. She says the BCBS fee schedule states an established level 4 office visit earns $85, whereas a new level 4 office visit generates $103.
Use the Web for verifications. "You can verify a lot now through carriers' websites and through your practice management software. It takes time, but it may cost you if you don't follow through," Campodonico says. Websites make verifying patients' carrier eligibility before seeing them easier, so practices don't waste time submitting to the wrong carrier. Specialty practices can confirm if pre-certifications or authorizations are needed before they commit to a procedure, test, or surgery. Bookmark the common sites.
Keep your codes current. Sounds like common sense, but updates can slip by and trigger unnecessary claim denials. "I have seen many denials in practices for outdated CPT codes and ICD-9 codes that require a fifth digit," Campodonico says. "Also be careful with your secondary CPT/ICD-9 codes." She recommends researching the active LCD's available on the Cahaba GBA website (www.cahabagba.com) and other carriers' medical policies.
Be forthright about getting paid. "There's no sense in getting paid $58 by the carrier and not the $20 co-pay from the patient," Campodonico says. A practice waiving the co-pay in that example loses a fourth of their fee for that service. "If they forgot their wallet, send them to the nearest ATM or give them a self-addressed envelope. No one likes to ask for revenue. But if you don't, you're rolling the dice on whether you'll ever collect it."