Industry thought-leader and revenue cycle management expert, Elizabeth Woodcock, Principal, Woodcock& Associates, will discuss how achieving clean claims at first submission positively impacts medical practices. She will specifically address what insurance changes to expect with the start of a new year, and how to identify and prevent claim rejections and denials so your medical practice can exceed a 95% clean claims rate in 2020.

1. webinar
How Your Medical Practice
Can Exceed a 95% Clean Claims Rate
Elizabeth Woodcock, MBA, FACMPE, CPC January 28, 2020

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Agenda
2
Agenda
2
• Welcome & Introductions
• Fundamental Principles
• Engage Your Patients
• Focus on the Team
• Recognize the Domino Effect
• Obsess over Accuracy
• Provide Business Intelligence
• How Kareo Can Help
• Your Questions

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How to Participate Today
Type your questions
Download today’s resources
View today’s presentation

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Connect via Social
twitter.com@GoKareo
facebook.com/GoKareo
linkedin.com/company/kareo

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Supporting Your Professional Development
• PAHCOM has approved 1 CEU credit
• You’ll be asked at the end of the
webinar if you want a CEU certificate
• Certificates will be emailed within the
next few days
• Attendees must be logged into the live
webinar to receive credit

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Speaker
• DrPH (Student), Bloomberg School of Public Health,
Johns Hopkins University
• MBA, Wharton School of Business, University of
Pennsylvania
• BA, Duke University
• Fellow, American College of Medical Practice Executives
• Certified Professional Coder
• Author, 17 textbooks and more than 500 Articles
• Founder and Principal, Woodcock & Associates
• Founder and Executive Director, Patient Access
Collaborative
• Adjunct Assistant Professor, Rollins School of Public
Health, Emory University
• Former Consultant, Medical Group Management
Association; Group Practice Services Administrator,
University of Virginia Health Services Foundation;
Former Senior Associate, Health Care Advisory Board
Elizabeth W. Woodcock
MBA, FACMPE, CPC
Speaker, Author, Trainer
www.elizabethwoodcock.com

7. Fundamental Principles

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Fundamental Principles
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subscriber
number
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Garbage In...

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Fundamental Principles
Still in your Hands
[Edits / Errors]
ThePayer’sClaims
AdjudicationSystem

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Fundamental Principles
Edits/Errors
Rejections/Denials

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Fundamental Principles

12. Engage Your Patients

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Engage Your Patients

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Engage Your Patients

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Engage Your Patients

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Engage Your Patients

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Engage Your Patients
Patients who are
with their
providers’ bill
Source: Connance Consumer Impact Survey 2014

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Engage Your Patients
How can you solve for this?

19. Focus on the Team

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Focus on the Team

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Focus on the Team
✓ Directors of First Impressions
✓ Directors of Denial Prevention
✓ Directors of Price Transparency
✓ Directors of Point-of-Service Collections
Directors of Clean Claims

22. Recognize the Domino Effect

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Recognize the Domino Effect

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Recognize the Domino Effect

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Recognize the Domino Effect
• Staff resourcing
• Cash flow
Source: The Physician Billing
Process: Potholes in theRoad
staff, resources and interest.
Actual Cost of a Denied Claim
to Getting Paid. 2016. Includes

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Recognize the Domino Effect
Aging returns to ZERO, but the probability of payment is cut in half

27. Obsess Over Accuracy

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Obsess Over Accuracy
Medication Reconciliation

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Obsess Over Accuracy

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Obsess Over Accuracy
24 to 72 hours

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Obsess Over Accuracy

32. Gather Business Intelligence

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Gather Business Intelligence

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Gather Business Intelligence
https://cgsmedicare.com/partb/education/claim_denials.html October 2019

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Gather Business Intelligence
 Develop a Clean Claims Guide
▪ Action plan
Registration/Eligibility
▪ Step 1: Request information from guarantor/patient
▪ Step 2: Verify eligibility directly with payer
▪ If ineligible, return to step 1; ? → perform discovery; →
inform patient he/she is self-pay and collect
▪ Step 3: Etc.
▪ Timeframe
▪ Thresholds

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Gather Business Intelligence

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Gather Business Intelligence
Assign a Clean Claims Champion
Offer a Course on an Online Learning Platform
Report (blinded) Clean Claims rates for all Providers
Create Clean Claims Certification
Reward Employees/Teams through Recognition
Spotlight Clean Claims “Best Practices”

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Conclusion

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Awards and Rankings
Growth Awards
The speed at which medical
practices are moving to Kareo and
referring it to other providers.
Software Reviews and Rankings
3rd party recognition, driven by
direct customer feedback, equals
trust and credibility.

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Kareo Platform

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Kareo Platform Extensions

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How to Participate Today…
Type your questions
-- Questions After the Webinar --
888.775.2736 x1
sales@kareo.com

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Connect with Kareo
Stop by and say hi!
Kareo @GoKareo GoKareo
3353 Michelson Drive, Suite 400
Irvine, CA 92612
(888) 775-2736

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Speaker
Elizabeth W. Woodcock, MBA, FACMPE,CPC
Principal,Woodcock &Associates
Atlanta,GA
404.373.6195
www.elizabethwoodcock.com
elizabeth@elizabethwoodcock.com
These slides are for the exclusive use of Kareo for the webinar: “How Your Medical Practice
Can Exceed a 95% Clean Claims Rate.”