Medical Billing Forum

Billing => Billing => Topic started by: dfranklin on January 10, 2010, 12:24:27 PM

Title: Filing paperwork
Post by: dfranklin on January 10, 2010, 12:24:27 PM
I am trying to get the control of my papers.  I have only a couple of providers and I have SOOO much paperwork. The company that trained me said that we don't need to keep the files that we can shred them since the provider has the originals. Once we have submitted and posted we don't need them.  Is this true?

What is common practice? Do you file everything just like to providers office? That would require A LOT of flinging space? If you do file do you have a patient folder for each patient or do you just file by DOS?  I have superbills/chart notes and EOB's and other insurance correspondance.  What do I do with all of these?  If I keep them how long do I keep them for? And how do i go back through to clear them out in order to not have them grow ridcously to where I need a storage just for files?

Help is appreciated!!!

Thanks!
Title: Re: Filing paperwork
Post by: Pay_My_Claims on January 10, 2010, 12:54:04 PM
look at OIG website, and your state and federal legislation regarding this issue
Title: Re: Filing paperwork
Post by: kwardbilling on January 11, 2010, 07:55:43 AM
The only paperwork that I keep is the logs of their sessions.  I return everything they send to me, EOB's, Intakes etc after I send the claim.
Title: Re: Filing paperwork
Post by: Michele on January 13, 2010, 09:34:37 AM
We keep papers on file.  Often we need to go back and look at something.  Also, I like to be able to go back to the provider and say "that's not what you gave me" when it is necessary, and unfortunately, it is necessary.

Just develop a GOOD filing system, and it makes things easier.

Michele
Title: Re: Filing paperwork
Post by: dfranklin on January 13, 2010, 10:05:24 AM
that is what i need help with....a Good filing system.  do yoe file by patient? by superbill and date? etc not sure why i am struggling with this but i seem to have a block with this... :(

thanks!
Title: Re: Filing paperwork
Post by: Michele on January 13, 2010, 10:08:40 AM
Over 70 providers  -  so  - we file by provider, by date, and we break up eobs from claim info and patient info.  Also, we break out Medicare & Medicaid eobs into different folders, since those are the ones we go back for most often.  If we have a 'difficult' case, we may have a folder for a specific patient.  But overall, not feasible for the size.

Michele
Title: Re: Filing paperwork
Post by: Pay_My_Claims on January 13, 2010, 02:41:10 PM
Over 70 providers  -  so  - we file by provider, by date, and we break up eobs from claim info and patient info.  Also, we break out Medicare & Medicaid eobs into different folders, since those are the ones we go back for most often.  If we have a 'difficult' case, we may have a folder for a specific patient.  But overall, not feasible for the size.

Michele


70 providers........slide me about 5 of them :-)
Title: Re: Filing paperwork
Post by: Michele on January 14, 2010, 05:52:29 PM
I have five I'd like to slip you but then you wouldn't think I was nice anymore.   ;D

JK

Michele
Title: Re: Filing paperwork
Post by: Pay_My_Claims on January 14, 2010, 05:53:29 PM
I have five I'd like to slip you but then you wouldn't think I was nice anymore.   ;D

JK

Michele


LOL, if you have seen who I have worked for you would go ahead and give me my free pass into Heaven!!
Title: Re: Filing paperwork
Post by: dfranklin on January 15, 2010, 11:28:57 AM
Does anyone use or though of using an electronic filing/storing system? Any suggestions on software companies?  I was thinking that maybe we should convert them to electronic files and store them online...but I don't know if it is too cost prohibitive and/or to time consuming...was just thinking it would free up a lot of space and file cabinets.

Thoughts?

PS Michele, I don't mind you can slide me over a couple of those pain in the....ones too :)
Title: Re: Filing paperwork
Post by: Pay_My_Claims on January 15, 2010, 11:41:17 AM
df  stop cutting into my begging time  ;D
Title: Re: Filing paperwork
Post by: Michele on January 16, 2010, 10:12:10 AM
THe worst part is I probably have enough to go around!  LOL  JK 

Anyway, I have never used an online storage - sorry!  Can't make any recommendations.

Michele
Title: Re: Filing paperwork
Post by: bobbie on January 16, 2010, 06:44:22 PM
So, going back to this Filing paperwork entry. We have over 100 providers so you can imagine the paperwork between faxes, emails, eobs etc. Everything I do is filed according to 'date posted' so when I close the books for the month every transaction done that month can be found within that set of papers. I put a coversheet on that clump of papers:  Dr. Pain in the A   
                                                    closing report
                                                      12/1-31/09
                                                       income= $_____
                                                       Charges=$__________
so that if I later need to go back and review a charge or EOB I can just retrieve that bulk from my file or labeled box...it's quick and easy. So I've never managed paperwork other than by posting date.
Is there an easier way? I keep everything for 10 yrs, although I think 7 is the law. How do ya all do it? I'd appreciate any feedback.
Bobbie
Title: Re: Filing paperwork
Post by: Pay_My_Claims on January 16, 2010, 10:04:58 PM
Basically the same. I file everything by the date posted per provider . Any documents I receive are date stamped and documented in the clients file so if i have to go back to it, it has the date to retrieve easily. I print off the AR for that provider for that month. It has posted charges, and posted payments, close out the month, and prepare for the next month.
Title: Re: Filing paperwork
Post by: Michele on January 18, 2010, 08:15:33 AM
We file ours similarly, by provider, by date posted.  We separate claims from eobs.  Folders are switched every month, so going back to locate something is not too bad.

Michele
Title: Re: Filing paperwork
Post by: PMRNC on January 20, 2010, 09:38:21 AM
Quote
The only paperwork that I keep is the logs of their sessions.  I return everything they send to me, EOB's, Intakes etc after I send the claim.

Yikes you guys missed this.

YOU should be keeping your source documents for the same federally required time. If your state law is longer than you use the state law's period (record retention)  Anything you use to file a claim is a source document and MUST be retained by YOU as well as the provider.
Title: Re: Filing paperwork
Post by: midwifebiller on January 20, 2010, 11:15:05 AM
For what it's worth, here's how we file.  Each provider has three files.

File folder 1: Provider information, W-9, licenses and certifications, contract information, communications worth saving, etc.
File folder 2: Patient registration forms and superbills. These are filed alphabetically. For our smaller practices, it's just one folder. For larger practices, it's multiple folders, A-G, H-M, etc. For large practices, it's one folder per letter.  I only file by the first letter of their last name, not any further.  For example, all the Millers, McNarys and Matsumotos are in the M folder. I do not take the time to make sure it's Matsumoto, then McNary and finally Miller (I'd be filing all day!)
File folder 3: EOBs. These are filed chronologically by the date on the EOB. Again, for our small practices, it's just one folder and we file each EOB behind the rest. For larger practices, we have 12 folders, one for each month of the year. Any problem insurance companies get their own folder.

We frequently have to go back and look at the original document, and this system has served me well for many years.  I am now using a web-based billing program that has online document storage.  This has been a great time saver--the documents are just a click away instead of having to search in a file folder. I have looked into electronic file storage, but it was too expensive.  And with the document storage right on the billing program, it became a moot point.

I keep two years worth of files in the filing cabinet. Every January I pull older superbills and EOBs out, put them in a box, label it and put it in the crawl space under the house.  It really doesn't take that long and it feels so good to get rid of those old papers! (I have also hired teenagers to do this for me when I am too busy.)  I have also hired a professional shredding company to come and take the 7+ year old boxes off my hands.

Hope this helps!

~Kelli
Title: Re: Filing paperwork
Post by: dfranklin on February 05, 2010, 11:13:27 AM
What about chart notes?  I have been shredding those things but even if I filed the way mentioned above I would have large batches of paperwork filed in a stack for the month. Now my provider sends me a note/request today to send all chart notes from 10/7/09 tp 1/8/10 to Geico.  Now even if I kept them this request would not be easy to retrieve from our files as they will be multiples in each big monthly pile and trying to locate and retrieve the notes from in this case 4 filed piles would be a difficult task.  Is it a normal expectation for a provider to request this from us? Would you guys be able to do this based on how you file or would it be normal to request the provider to give those to us to send in? What would you say to the provider so you don't sound like we are not doing our jobs and that we are working within industry standards?
Title: Re: Filing paperwork
Post by: QueenAlicia on February 05, 2010, 12:40:14 PM
Over 70 providers  -  so  - we file by provider, by date, and we break up eobs from claim info and patient info.  Also, we break out Medicare & Medicaid eobs into different folders, since those are the ones we go back for most often.  If we have a 'difficult' case, we may have a folder for a specific patient.  But overall, not feasible for the size.

Michele


70 providers........slide me about 5 of them :-)

LOL, Charlene I heard that!  ;D
Title: Re: Filing paperwork
Post by: DMK on February 05, 2010, 06:53:41 PM
Forgive me if I gasp!  Why would you be responsible for keeping treatment notes? Those should be in the patient's treatment file at the Dr.s office!  If the insurance company requests notes, the doctor should copy and send them, or a copy service should come and copy them.  They wouldn't send the copy service to the billing service to copy records!

Dina
Title: Re: Filing paperwork
Post by: kwardbilling on February 06, 2010, 09:48:02 AM
I agree on this one.......I wouldn't keep any treatment notes etc.......
Title: Re: Filing paperwork
Post by: Pay_My_Claims on February 06, 2010, 10:21:54 AM
Forgive me if I gasp!  Why would you be responsible for keeping treatment notes? Those should be in the patient's treatment file at the Dr.s office!  If the insurance company requests notes, the doctor should copy and send them, or a copy service should come and copy them.  They wouldn't send the copy service to the billing service to copy records!

Dina

For those coding, I guess they would use them but since I don't, I don't need them either. Depending on what service you bill for will depend on how much paperwork you receive. For my DME provider, I can get 1-2 pages per client. It will have the demographics/insurance on one, then the dme order/dx on the other. I verify the insurance, and obtain the auth. Once the person is OK, I will email or fax to them the log of clients scheduled for that week who are OK'd for their AFO. This is great that they see the md, he writes the rx for the afo, and they send that to me with the dates they are scheduled to come in for the fitting. Now only notes I may get is if one of the Medicare plans asks for a LMN or clinic notes, the MD will fax to me, I will send to the INS company, and file that. What I am about to do is change over to paperless faxing and have all documents put on a memory stick. This way all information is easily kept.
Title: Re: Filing paperwork
Post by: Michele on February 06, 2010, 07:16:15 PM
I have to say, I agree.  We don't keep copies of any treatment notes and it would be impossible to do so.  If a provider gives us notes to attach to a claim, we attach them to the claim.  The only time I EVER keep notes is if it is a notoriously problem account, where the insurance carrier continuously requests notes and in those instances I have a special file for the patient with all billing, eobs, correspondences, etc.  For 70 providers we usually have less than a 1/2 dozen of these patients at any time, so it's not common.  When we receive a request for notes, we request them from the provider, then forward them on.

Michele
Title: Re: Filing paperwork
Post by: dfranklin on February 06, 2010, 07:37:06 PM
The provider is keeping his own records.  It is just the fact they automatically send me the notes for PI claim cases as they typically want the note sent with each claim. The provider is probably just assuming I still have it but I to just send it along with the claim and do not keep it.  He is probably just looking at saving time and why send it again when he already did and assumes I just file it. 

I just wasn't sure what the "standard" or norm is out there and before I told him I don't keep copies and that he would have to resend them and I wanted to find out if I was within the norm.  By the sounds of it I am, THANKS to everyone that responded.  This forum is really great!!! I love everyone on here that helps one another.

Thanks for the ideas on the filing...I am trying to work on incorporating these somehow.  But I think I have a general idea of how to do it. 

Next question along the same line: What do you do on the "problem" superbills/EOB's/Patient info sheets?  Ie superbill with not patient info sheet (new patient), patient info sheet missing insurance ID or Diag codes, EOB says carrier can't locate member etc...all of these need something from the provider to move forward with it.  Currently, I keep all of these in a folder, send the requests to the provider and wait.  The provider will send a stack of things that may or may not include the info/item(s) that I needed in for some (or all) of my problem stack.  I then have to figure a way to cross check each item because I don't know whether the item is something needed in the problem stack or just a new item to get entered, billed out etc.  The provider does not make an distinction on it to let me know this is a requested item from me.  Any ideas or suggestions on this one? How do you handle these?

Thanks!
Title: Re: Filing paperwork
Post by: Pay_My_Claims on February 06, 2010, 08:01:02 PM
Anything I get I keep, its a matter of how you want to store it. I don't want to have paper everywhere, so you can scan it into your system create a folder for his charts. This can all be saved on a memory stick.
Title: Re: Filing paperwork
Post by: AD on February 06, 2010, 08:57:31 PM
Hi, I just started my externship, which I have not been learning as much yet, but what I have to do is
Scan, scan and scan, yes this is a very small Scanner Machine, which I am scanning superbill by Providers and those by months(there in days) when I scan for example Dr.Gonzales Superbills of Dec 9, I do export this data to a PDF FILE, UNDER THIS DR. GONZALES NAME... FROM THERE, ONCE A WEEK THE MANAGER storage evething in a Disk and this Disks (It is like to record music,actually with Roxio) and then this goes to a folder with this Drs.Gonzales lots of CDS.....and I guess the Manager returns all the paperwork to the office... but THERE IS NOT FILING ON PHISICALL FOLDER.... WHICH IS GREAT...know  Probably I will keep asking a couple question once a while......Ana Dioguardi....from NY.
Title: Re: Filing paperwork
Post by: Michele on February 07, 2010, 01:16:58 PM
We have a 'current folder' for each provider.  It is a hard cover folder with pockets.  Any work that comes in for that provider goes in the folder.  When we need something, something is missing, or we see a problem, we send an email/faxed note, or whatever works, to the provider with a list of all needed.  We attach the list to the papers waiting for the info, then put it in the pocket of the current work folder.  When the response comes back, we know exactly where to find the papers.  And if we go to do the next batch of work, and the responses weren't received yet, we send a second request.  Works good for us.

Michele
Title: Re: Filing paperwork
Post by: PMRNC on February 13, 2010, 12:06:28 PM
I'm sorry but you are all incorrect. ANYTHING you receive to generate ANY claim is considered a source file. An Audit if done would need to have everything used for any claim. IF your provider sends treatment notes that are being used to code/submit a claim.. that is a SOURCE document.
Title: Re: Filing paperwork
Post by: Michele on February 13, 2010, 03:56:39 PM
When we receive notes, they are not used to create the claim, they are strictly given to us to attach to the claim.  All information we use to create the claim is in the other paperwork, which we keep all of.  That's why we don't keep copies of the notes.  Doesn't that fall in a different category?

Michele
Title: Re: Filing paperwork
Post by: Pay_My_Claims on February 13, 2010, 07:05:29 PM
I'm sorry but you are all incorrect. ANYTHING you receive to generate ANY claim is considered a source file. An Audit if done would need to have everything used for any claim. IF your provider sends treatment notes that are being used to code/submit a claim.. that is a SOURCE document.

I don't think we ALL are incorrect as I stated I don't code, so I don't obtain notes from any physician or dme provider. If i have to obtain a CMN because it is REQUESTED by the insurance company to pay a claim, then I ask the physician for it resubmit with that cmn or other documentation, and that is kept with the claim. i don't ask for notes as I don't code claims. I only receive 1-2 documents for my billing. I have no idea why anyone needs all of that, but if I did get them, I would have them e-faxed and saved on a stick. I don't have the room for all that paper.
Title: Re: Filing paperwork
Post by: PMRNC on February 14, 2010, 09:13:48 AM
Ok, to put it simply.. IF you are sent ANYTHING to do with a claim..that makes that claim a claim (notes, CMN, etc...) It is considered a "source document".  You have two issues: the provider is responsible for maintaining THEIR records. As a billing company YOUR records are separate and anything you use to generate or go with a claim is your source document and must be retained. For example, I have a client who I will attach a treatment report to a claim because the carrier requires it after XX visits. That treatment report is sent to me by the provider, I attach to the claim, that is MY source document. IF the provider chose to send it apart from the claim it wouldn't need to be retained by me because it wouldn't need to become my source document. Charlene, what you are doing is fine.. if you do get info which becomes your source document it's fine to store them on a memory stick, so long as you have access to them when/if needed, that's proper storage and retention for source documents. If I have a question about something my provider coded and I need to look at the notes, the provider sends me the notes.. once she sends them to me they are my source documents and therefore subject to retention.
Title: Re: Filing paperwork
Post by: Pay_My_Claims on February 14, 2010, 12:01:45 PM
And I agree, you have to follow the record keeping laws of your state and also the federally mandated laws. When I attach a faxed CMN to the claim, because I had to obtain it, It would be date stamped when I received it (before e-faxing) and it is kept on file. The reason this is important is the CYA rules!! I DTA (Dont Trust Anyone). If I have proof of the cmn being sent to me, any audit of my company will show that MD X sent me this CMN to show the client equipment was medically necessary. If the provider does not have proof, how will I have it??? Also about a month ago Medicare came in and did an audit of one of the DME providers I bill for (W-2) They pulled 10 random clients. We had 100% of everything on all but 1. The client had BCBS primary and Medicare secondary. We were not able to locate any records on that client. We will still come out fine in the audit, but it is truly a lesson learned. If I was billing for this provider under my own company........where would I stand knowing I placed the KX modifer on the claim which states all required documentation was received???
Title: Re: Filing paperwork
Post by: PMRNC on February 15, 2010, 11:21:02 AM
Exactly my point Charlene.
ONCE your client sends you ANYTHING it should be retained..that's the best way to CYA.