As the year comes to a close, the hustle and bustle in medical offices reach a peak. December is a critical time for managing reports, submitting last-minute claims, and handling insurance recoupments. Navigating this busy period requires meticulous attention to detail and a well-thought-out strategy. In this blog post, we'll guide you through essential steps to ensure your medical office not only wraps up the current year successfully but also sets the stage for a thriving start in the new year.
Run Year-End Reports: While regular monthly reports are beneficial, evaluating your overall fiscal year and billing performance is crucial. Run essential reports such as Accounts Receivable and Mismatch reports from your EMR system. Compare them to the previous year to identify areas for improvement and maximize reimbursements. Consider other reports that can provide insights into your office's performance throughout the year.
Submit All Claims: Adopt a proactive approach to claim submissions. Develop a consistent workflow for daily or weekly filing to avoid untimely submissions. Aim to submit all outstanding claims before the year-end to prevent issues with timely filing, denial deadlines, or appeals. Take advantage of the period when insurance processes slow down to ensure a smoother submission process.
Prepare for Year-End Recoupments: 'Tis the season for insurance recoupments. As insurers conduct audits, it's essential to perform an in-office audit to identify common take-backs and stay informed about the latest regulations. Be aware that some insurances can perform recoups as far back as six years.
Authorizations & Verifying Eligibility: Get a head start on the new year by focusing on enrollment changes. With patients likely to have insurance changes, make it a habit to ask for updated insurance information and verify eligibility for every visit. Maintain thorough verification and authorization records to prevent claim denials for "not medically necessary."
Perform Write-Offs: While no one likes taking a loss, preparing for write-offs is essential. Thoroughly check your billing workflow, explore appeal options where applicable, and understand your insurance contract terms. Be proactive in addressing denied claims due to timely filing, incomplete documentation, or non-medically necessary services.
Create or Reshape a New Year Workflow: Evaluate your office's workflow with an end-of-year team meeting. Reflect on the challenges and accomplishments of the past year and collaborate on shaping goals for the upcoming year. Consider bringing in a medical consulting specialist or company for guidance. Embrace a growth mindset to foster continuous improvement.
Tackle Your Patient Collections: Given the increased financial responsibility on patients, it's crucial to address patient collections before the year ends. Check eligibility before patients arrive, implement a patient responsibility policy, collect payments at the front desk, and ensure proper communication about statements to patients through mail or phone.
Conclusion: By following these comprehensive steps, your medical office can navigate the year-end rush with confidence, ensuring a smooth transition into the new year. Taking the time to evaluate and optimize your processes will contribute to a successful and prosperous future for your practice.