A blog series by Matthew Behringer, Managing Partner of the clearinghouse TKSoftware.
Is your clearinghouse a goldmine? In other words, does your clearinghouse provide the tools and the tech to dig into the revenue cycle, accelerate cash and make your business office more efficient? Well, it should. This is a bold statement indeed but in the following series of blogs I will show you why it’s true.
Take Control
At its core the revenue cycle is not complicated. There are aspects of it that are under your control and aspects that are not. The key is to control what you can. Here is what I mean…
- Get the Demographics right
- Confirm eligibility
- Code the claim correctly
- File the claims as soon after the encounter as possible
- Work the rejections as quickly as possible
- Work the denials as quickly as possible
- Learn from the rejections/denials and adjust to reduce future rejections/denials
From this list the billing office is faced with several moments and has a choice either to act and accelerate revenue, or not act which will result in delays.
Nothing new here…all very fundamental, but it’s mastering the fundamentals that lead to success.
Leverage Your Partner’s Strengths
Where does the clearinghouse fit into this process…Everywhere! Your clearinghouse should be able to provide you with the reports, claim scrubbing, and claim editing tools that you need to act in these critical moments and accelerate revenue. Here are some examples. We will explore these in more detail in future blog posts.
Reports:
- General filing, rejections etc.
- Front End Rejections
- Rejection Reports
- Denials
Scrubbing:
- Provide basic as well as complex edits on claims to correct, insert, or replace claim content as needed before filing with the payers.
Editing:
- The quickest way to get a corrected claim back to the payer is to edit it in the clearinghouse system.
Any clearinghouse can file clean claims. Any clearinghouse can move data from point A to Point B. The clearinghouse that is a goldmine helps you navigate the difficulties because it’s the difficulties that destroy your efficiency and consume your time.
Do you expect enough from your clearinghouse?
About the author
Matthew Behringer is the Managing Partner of TKSoftware and has been serving the revenue cycle since 2003. You can contact Matthew at [email protected] and learn more about TKSoftware at www.friendofmedicine.com.
