Compliant coding is a key to getting paid appropriately for services rendered. However, there is an underlying support system that should be frequently reviewed and updated in conjunction with a coding compliance program. The focus of this review is to verify that processes are in place to get correctly coded services billed to the correct party in a timely manner and that payments are appropriately reviewed and applied to accounts. By adding a few more checkpoints to an existing compliance review, a practice may efficiently find and correct processes that are causing lost revenue or improper billing.

Are patient demographics and insurance information updated for each scheduled visit?

Is there evidence of a system to verify benefits, deductibles, coinsurance, and co-pay amounts prior to each visit? Time must be spent on these activities, but it is often after a denial is received due to outdated insurance information. With many payers...

You do not currently have access to this content.