Billing Training

CHART AUDITS: Should be done on a daily basis & faxed to owner monthly, thus all evaluations for the month must be listed and audited on this form.

Chart Audit Form Print Double Sided & complete Monthly (fax to owner on the last working day of the month).

PAYMENT WORKSHEET: This document that is part of the new pt paperwork is the sole responsibility of your position. The front desk can fill it out initially if they have time, however it must be audited thoroughly by the you & signed off on. If the front desk initially creates the data, then there will be two names/signatures on this document. The accuracy of the data on this document is huge for setting the stage for the patient reimbursement & Loyalty.

Payment Worksheet 2018

WC/AUTO:

Each WC claim must include the claim + the visit documentation. For the Evaluation day the eval + note must be sent with the claim.

For massage these are insurance claims. Print claim in Heno as PT, however white out provider & input the MT Name, NPI#. Mail claim (or fax) with the daily note (and the eval if it is the first visit). Remind MT, daily notes are due that the medical massage is completed.

Specific Wording which must be on WC/AUTO Claims to avoid Denials: WC/AUTO documentation must state (copy & paste to notes as needed) :

1) Time was spent Direct one-on-one patient contact 2) This may not be comprehensive. Contact us for the original note. 3) Unless otherwise noted, all time-based codes are in 15 minute increments & total time spent is 60 minutes. 4) Body Part(s) treated is specifically related to ICD 10 code as listed.

Submit Claims Daily:

Clean Claims: this is when the claim has all areas checked off and gets the green light. Map for Process for Assessing Clean Claims:

billing claims map

Go to Encounters Tab- check each claim for auth if needed- if auth is needed and it is not there then make sure auth was submitted. Below is an example of a encounter where the status is Waiting on Auth while awaiting auth (common for Aloha Care, Ohana, MDX HI). This is normal to do for the eval until auth is secured. Remember to make sure auth is submitted same day as EVAL. or we risk non payment.

Billing CPT Code Modifiers: Heno should catch these and input them automatically. This does not always happen. Here the are the common ones to look for: For Example when 97140 and 97530 are used in the same visit the “59” modifier must go in with cpt code 97530. The Green side is where the “59” modifier is inputted. Cheat Sheet:

EDI TAB: (daily) : clear daily all non rejected claims.

Heno Statements:

(copy & paste #1) Arrange payment to avoid interest and penalties that may be applied to your account.

(copy & paste #2) Your account is past Due. Once again, to avoid further penalties payment must be made by INPUT DUE DATE .

Collections:

When sending out collection statements for pt portions input that data into Notice Prep Statements box and date notice statement was sent with past due notice I also like to be as detailed as possible, this example does not show it but I will put this info of amount due etc so if pt contacts us we can easily provide them this info with EOR uploaded to pts account etc. . When payment comes in, apply payment to pts account and then input a note that this was received dated per below example. Make sure to do this or there is the change that the pt will be billed again & then there will be an angry phone call coming your way. Collections should be completed along with chart auditing ie; during chart auditing you note that a pt had a deductable that was not collected on etc.