During a recent trip to a Billers and Coders conference, the importance for keeping your practice in compliance was reinforced in several content-rich workshops.

1. Accomplish Compliance with Medical Practice Management Systems
During a recent trip to a Billers and Coders conference, the importance for keeping your
practice in compliance was reinforced in several content-rich workshops. This
responsibility together with a rapidly changing landscape in coding and legislation make
the selection of a Medical Practice Management System even more prescient.
The take-away illuminated three considerations practice managers and billing managers
should look for in their evaluation:
 A system managed by a team of billing experts always alert to coding changes
 Built-in alerts to notify operators of important reminders and pending work
 Productivity enhancement tools to streamline accurate claims to enhance financial
sustainability
Here are some of the findings to address the highlighted topics.
 A system managed by expert billers alert to coding changes.
o CMS regularly issues rule changes and updates. These changes directly
impact your ability to submit clean claims. Claim denials cost your practice
money in time and lost revenue. Not only do you require accurate claims first
time and every time, a fully featured system must be able to both submit
electronically and in return post ERA payments by auto-adjudication to
maximize your biller efficiency.
o To best accomplish this capability, the system must be managed by a team
of billing experts, all seasoned billers able to understand and interpret code
changes then build in those changes as system updates, timely and
accurately. This capability is best accomplished via a software-as-a-service
model, or cloud-based via secure internet access.

2.  Built-in alerts to notify billers.
o Attending this recent coding/billing conference reinforced one thing for
certain – the responsibility of managing the rules, preventing code conflicts,
preparing timely, accurate claims that will get reimbursed is immense. Your
system must permit you to memorialize notes to track all touches to patient
records, then alert you to reminders, notify you when claims are ready in que
and when ERAs are received.
o Your time is a valuable resource. Let a system thoughtfully designed with
helpful tools work with you to enable the most efficient and effective
application of available resources.
 Productivity enhancement tools to streamline accurate claims to enhance financial
sustainability.
o As quickly or as often as CMS issues rules and changes, the best system
leverages the capabilities of its IT support team to interpret the rule changes
and incorporate those into built-in scrubber rules.
o A properly designed built-in scrubber applies the rules to ensure accurate
claim submissions generate timely reimbursements.
Certainly, there are many factors influencing the success of a medical practice, choosing
the right billing system holds the potential to both compliment hard working staff and
positively impact the successful claim and reimbursement life cycle.
In this light, perhaps these observations prove helpful to those now in the process of
medical billing system evaluation.