How Your Billing Company Can Exceed a 95% Clean Claims Rate
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This webinar discussed how medical billing companies can achieve a clean claims rate over 95%. The presenter outlined fundamental principles like ensuring accuracy of submitted claims to avoid rejections and denials. Engaging with customers to understand billing issues was emphasized. Focusing on partnerships with providers and recognizing how denials can negatively impact staffing and cash flow was also covered. The webinar provided tips for obsessing over claim accuracy, using business intelligence to track denials, and working with clients to develop clean claim action plans and certification. The webinar concluded by describing Kareo's billing platform and extensions that could help providers achieve clean claim goals.
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How Your Billing Company Can Exceed a 95% Clean Claims Rate
- 1. webinar How Your Billing Company Can Exceed a 95% Clean Claims Rate Elizabeth Woodcock, MBA, FACMPE, CPC January 15, 2020
- 2. kareo.com Agenda 2 Agenda 2 • Welcome & Introductions • Fundamental Principles • Engage Your Customers • Focus on the Partnership • Recognize the Domino Effect • Obsess over Accuracy • Provide Business Intelligence • How Kareo Can Help • Your Questions
- 3. kareo.com 33 How to Participate Today Type your questions Download today’s resources View today’s presentation
- 4. kareo.com 44 Connect via Social twitter.com@GoKareo facebook.com/GoKareo linkedin.com/company/kareo
- 5. kareo.com 55 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 • AAPC has approved 1 CEU credit • If you would like a certificate, please email webinars@kareo.com • Certificates will be emailed within the next few days • Attendees must be logged into the live webinar to receive credit *This program has the prior approval of AAPC for 1 continuing education hour. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.
- 6. kareo.com 66 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
- 8. kareo.com 88 Fundamental Principles ...Garbage Out! Unspecified ICD-10code Incorrect subscriber number No authorization number Garbage In...
- 9. kareo.com 99 Fundamental Principles Still in your Hands [Edits / Errors] ThePayer’sClaims AdjudicationSystem
- 13. kareo.com 1313 Engage Your Customers
- 14. kareo.com 1414 Engage Your Customers
- 15. kareo.com 1515 Engage Your Customers
- 16. kareo.com 1616 Engage Your Customers
- 17. kareo.com 1717 Engage Your Customers Patients who are with their providers’ bill Source: Connance Consumer Impact Survey 2014
- 18. kareo.com 1818 Engage Your Customers How can we work together to solve for this?
- 19. Focus on the Partnership
- 20. kareo.com 2020 Focus on the Partnership
- 21. kareo.com 2121 Focus on the Partnership 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
- 23. kareo.com 2323 Recognize the Domino Effect
- 24. kareo.com 2424 Recognize the Domino Effect
- 25. kareo.com 2525 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
- 26. kareo.com 2626 Recognize the Domino Effect Aging returns to ZERO, but the probability of payment is cut in half
- 28. kareo.com 2828 Obsess Over Accuracy Medication Reconciliation
- 29. kareo.com 2929 Obsess Over Accuracy
- 30. kareo.com 3030 Obsess Over Accuracy 24 to 72 hours
- 31. kareo.com 3131 Obsess Over Accuracy
- 33. kareo.com 3333 Provide Business Intelligence
- 34. kareo.com 3434 Provide Business Intelligence https://cgsmedicare.com/partb/education/claim_denials.html October 2019
- 35. kareo.com 3535 Provide 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
- 36. kareo.com 3636 Provide Business Intelligence
- 37. kareo.com 3737 Provide Business Intelligence Request the Assignment of a Clean Claims Champion Offer a Course on an Online Learning Platform Report (blinded) Clean Claims rates for all Customers Create Clean Claims Certification Reward Customers through Recognition Spotlight Clean Claims “Best Practices”
- 39. kareo.com 3939 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.
- 41. kareo.com 4141 Kareo Platform Extensions
- 42. kareo.com 4242 How to Participate Today… Type your questions -- Questions After the Webinar -- 888.775.2736 x1 sales@kareo.com
- 43. kareo.com 4343 Connect with Kareo Stop by and say hi! Kareo @GoKareo GoKareo 3353 Michelson Drive, Suite 400 Irvine, CA 92612 (888) 775-2736
- 44. kareo.com 4444 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 Billing Company Can Exceed a 95% Clean Claims Rate.”