Keeping Track of Your Surgeries

March 22nd, 2013 - Debra Sanders
Categories:   Benchmarks   Billing   Bundling   Claims   Collections  
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    When working my AR, I work my surgeries separately since that is my big money or bulk money.  I want to make sure I get that money in as quickly as possible.  For me, I created an excel spreadsheet.  The columns are:  DOS - PATIENT NAME/MRN - PROC NAME - CARRIER(S) - CPT® - MODIFIER - BILLED - PRIMARY PD - SECONDARY PD - ADJUSTMENT - PERSONAL BAL - TODAYS DATE - COMMENTS.  I also color code my spreadsheet.  

    After I enter my surgeries in the system, I then pull up my spreadsheet and enter them on that by line item and auto sum each.  I highlight it a dim yellow.  This means I'm waiting for the insurance to pay.  Light blue means primary paid and I'm waiting on the secondary to pay.  Bright green means I appealed something.  And tan means the insurance(s) have paid.  I don't work my personal balances off this spreadsheet because I work those off of the personal balance report to keep it simple.  When I work my spreadsheet, I enter the date I'm working it and any comments to reflect my work along with the reimbursement information when it pays.

    Each month I am able to email my providers so they know what I'm doing with their surgeries and how I'm working to get them paid.  Plus color coding makes it easy to work.  I work all the yellows first, blues second and I have my appeals on my calendar to followup on.  The tans I can just skip because that means the insurance(s) have paid correctly.  I don't delete any until the following year.  Once I have all the previous years done, I will then delete those so I don't end up with 1000 pages.  

    Now when I work my regular AR report, if I come across a surgery I will take a look at it and work it if I need to, if I see I've already worked it I move on.  Not only has this been helpful in keeping me accountable and "owning" my AR, but it has helped in maintaining a good follow-up on them as well.  

    Even if you just write them in a book, or maybe a ledger of some kind.  Either way, don't loose track of your folllow-up on your big money.  It not only shows you your reimbursement on them, any contract processing errors made in paying you, but it helps to keep that big money coming in alot quicker.  So pick your method and stay on top of those surgeries as well as keeping your provider informed.  Sometimes you both can even learn something from a coding change or reimbursement issue by keeping at least your surgeries separate. 

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