Clip and Copy: Keep your billing on target

A periodic audit will identify problems early on, before they do too much damage to your revenue flow.

"A simple missed coding modifier can cost a practice thousands of dollars a year," says Keith C. Borglum, a consultant with Professional Management and Marketing in Santa Rosa, CA. "To avoid the long-term financial impact of errors or omissions, it's important to audit the billing process periodically."

You can do that with the form below, from Medical Practice Forms: Every Form You Need to Succeed, by Borglum and Diane M. Cate. After performing an initial audit, you should repeat the process annually and about one to three months after a change in staffing, Borglum advises.

Use the checklist to confirm that your staff has all the requisite billing reference materials and reports, that your fees are adjusted as needed, that modifiers are used properly, and that rejected or downcoded claims are assessed. "When your practice receives less than the expected amount for a claim, a staffer should determine the reason and review the records to see how many similar claims have been denied or downcoded, or if there is a problem with a specific code," says Borglum.

"This billing review isn't meant to be a full Medicare compliance audit, which is far broader in scope," Borglum adds, "but merely to confirm that the basic tools and procedures are in place."

Other forms and patient handouts are available in the Clip and Copy section of our Web site at www.memag.com .

Gail Weiss. Clip and Copy: Keep your billing on target.

Medical Economics

Aug. 20, 2004;81:60.