Author Topic: Follow Up  (Read 3705 times)

gderilus

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Follow Up
« on: October 28, 2009, 09:19:35 AM »
Can anyone tell me how they keep track of claims submitted for follow up. I'm very new to billing and I'm having a hard time keeping track of the claims so that I can follow up on them. Do I have to make a list of them or what.

Pay_My_Claims

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Re: Follow Up
« Reply #1 on: October 28, 2009, 10:33:27 AM »
You should have an AR

jcbilling

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Re: Follow Up
« Reply #2 on: October 28, 2009, 10:47:50 AM »
Most practice management software have reporting abilities that allow to see what is outstanding. I would check with your software vendor to see what report is most helpful for you.

MBP

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Re: Follow Up
« Reply #3 on: October 28, 2009, 11:15:50 AM »
does anyone use Office Ally's PM? i have a question about the AR. billing statements only appear on the statement list if i hit "complete" or if i check "yes" for print reports. so if i do, aging reports will give me those outstanding balances and not paid claims is that correct? when i generate the billing statements then, i get everything, not just what patients owe but also what is outstanding on AR for insurance carriers. not sure if i am making any sense - my question is: when should i click "complete" or "yes" on print statements on each visit? when it is paid by ins and there is a balance for a pt or when it was billed? ALSO, aging reports go by DOS not date when the claim was submitted.. so if i am resubmitting claims, those balances will still be on my AR even if i just sent the claim out today.. i am confused by too many claims to watch for thats all..  ::)

Pay_My_Claims

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Re: Follow Up
« Reply #4 on: October 28, 2009, 11:40:34 AM »
i use it.... what type of report are you trying to create? You can get a report of all claims submitted if you like. They have varying ways of creating different reports. They also have the manual online if you need that.

MBP

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Re: Follow Up
« Reply #5 on: October 28, 2009, 11:53:11 AM »
you use office ally? i am glad to hear that an experienced biller uses it, it makes me much happier about my decision to go with them:) here is my problem. i started billing for my provider in august. the previous biller didnt give us any closing reports, so the provider wanted me to make sure everything has been billed for and paid for. so, not knowing any better way, i started to put everything in OA from all eobs from this year. i've been doing that while billing the current patients, so gosh, what a mess. i need a report telling me that it has been more than 30 days since i submitted the claim and it hasnt been paid yet. is there one like that? also, i am looking at my AR now. it tells me everything what has open balance, patient account or primary, secondary insurance payment, so that's good, but still.. i have many open balances from earlier this year as i was billing what i found wasnt billed, but it is in "over 90" - DOS is, but claim isnt. i am just confused over these reports. which ones do i really need?

MBP

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Re: Follow Up
« Reply #6 on: October 28, 2009, 12:06:25 PM »
also, i am getting ready to generate billing statements for patients (i learned from this forum that is the least confusing way to do it:)) and when i generate them, i dont only get patient balances but insurance balances on it too.. is it because i marked "complete" on the visit? should i only mark it when there is no balance but patient balance and i get it on the statement list then?

Pay_My_Claims

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Re: Follow Up
« Reply #7 on: October 28, 2009, 03:58:43 PM »
also, i am getting ready to generate billing statements for patients (i learned from this forum that is the least confusing way to do it:)) and when i generate them, i dont only get patient balances but insurance balances on it too.. is it because i marked "complete" on the visit? should i only mark it when there is no balance but patient balance and i get it on the statement list then?

Ok, the reason you are not getting any patient balances is because you haven't "posted" insurance payments. Once you post or "adjust" the insurance payments the applicable deductibles, coinsurance will drop to self pay, therefore giving a balance to the patient.

Pay_My_Claims

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Re: Follow Up
« Reply #8 on: October 28, 2009, 04:05:09 PM »
you use office ally? i am glad to hear that an experienced biller uses it, it makes me much happier about my decision to go with them:) here is my problem. i started billing for my provider in august. the previous biller didnt give us any closing reports, so the provider wanted me to make sure everything has been billed for and paid for. so, not knowing any better way, i started to put everything in OA from all eobs from this year. i've been doing that while billing the current patients, so gosh, what a mess. i need a report telling me that it has been more than 30 days since i submitted the claim and it hasnt been paid yet. is there one like that? also, i am looking at my AR now. it tells me everything what has open balance, patient account or primary, secondary insurance payment, so that's good, but still.. i have many open balances from earlier this year as i was billing what i found wasnt billed, but it is in "over 90" - DOS is, but claim isnt. i am just confused over these reports. which ones do i really need?

It isn't my personal software of choice, but I use it to keep my cost down until I get more clients. It's not bad, but I will upgrade at the top of the year.  I also work full-time. Yes there is a report that can do that. You might need to call me. send me an email and I will walk you through it. I'm a lil confused. When I go to my AR it prints column 30 60 90, so it will show the claim that is posted and how long the balance is open. You can also run a report on claims you filed 30 days ago.

MBP

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Re: Follow Up
« Reply #9 on: October 28, 2009, 04:21:42 PM »
thanks Charlene! i am doing some reading and research on these OA reports trying to figure it out. i understand the AR now and i can see how to get a report for claims filed 30+ days ago (although it doesnt tell me which one are still open and which ones have been paid). my questions is.... am i doing it the right way, trying to put in all these old visits for 2009 for the time i wasnt even billing for her or is there a better way to find out if there is anything what havent been billed or what the pt balances are? this is so time consuming.

PMRNC

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Re: Follow Up
« Reply #10 on: October 28, 2009, 08:18:40 PM »
No matter what PM software you use, good data in is good data out. The software will not have ESP (yet anyway)
In most softwares I use you have the capability of marking the claim status (paid, pending, rejected (patient resp), incomplete,) the better the software (IMO) the better the status codes. I can pull a report of rejected claims, claims waiting for info (incomplete), claims pending, etc weekly, daily, monthly etc.

But again, you have to have the data in there to pull any report. Unless the previous biller has reports for you, I see no other alternative. Look on the bright-side, your not loading someone else's headache. I prefer manual conversions anyway and I wouldn't rely on another billing companies reports for that reason. I like to setup my database how I like it.
Linda Walker
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One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Michele

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Re: Follow Up
« Reply #11 on: October 28, 2009, 08:41:53 PM »
Dodo in dodo out!

Sorry couldn't resist.   :)

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Pay_My_Claims

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Re: Follow Up
« Reply #12 on: October 28, 2009, 08:49:56 PM »
thanks Charlene! i am doing some reading and research on these OA reports trying to figure it out. i understand the AR now and i can see how to get a report for claims filed 30+ days ago (although it doesnt tell me which one are still open and which ones have been paid). my questions is.... am i doing it the right way, trying to put in all these old visits for 2009 for the time i wasnt even billing for her or is there a better way to find out if there is anything what havent been billed or what the pt balances are? this is so time consuming.

It depends on what you need to do. Like Linda, I keep a spread sheet as well. Now old billings unless I am rebilling them I see no reason to enter them in. What are you doing with those claims. I received back billings that had to be corrected. All of them were logged because I send them that spread sheet to go against what they keep when they send me charges. It makes sure all claims are billed out. Those that I had to refile are loaded into my PM system, while others that can be corrected via a reopening, or a copy of a RX or something of that nature, isn't entered. Its just on the log. My log has info such as

Patient, insurance, amount of claim, date billed, refile date if applicable, status etc etc.
I really try to not include old claims in my system. I will work an old claim, and have them post the payments and send out the final bill to the client if applicable.

MBP

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Re: Follow Up
« Reply #13 on: October 30, 2009, 12:10:38 PM »
what do you both mean by a spread sheet? something what you can copy out of your PM or are you saying you just type all the info into e.g. an excel sheet manually? talking about this, another questions is popping out - what is the best way of keeping hard copies of billing?? at the beginning i kept all routers at one locations, then after billing attached a claim to them and put them in another "waiting" drawer, when i received an eob i would make a copy for each claim and attach that to the router and the claim.. that is a lot of filing work and A LOT of trees... is that a waste of my time? i know i need to keep the routers and the eobs  ???obviously.. but is there a reason to print all the claims if they are all in office ally? maybe i could only print a summary with all of them instead of each one.. and eobs/ra.. maybe i can just keep those separatelly organized by insurance carrier and date instead of doing all this copying and stapling and filing.. any suggestions on how to stay organized, how to save paper and time and how to still have a backup for each case?? thank you all...

NuBiker

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Re: Follow Up
« Reply #14 on: October 30, 2009, 01:22:41 PM »
I use Office Ally, and I keep a spreadsheet in each patient's chart.
I use a spreadsheet because it gives me the big picture of the work flow.
It has columns - visit number, Authorized visit number (visit 1 of 6, 2 of 6, etc.), Date of Service, patient Copay, Amt Patient Paid, Date Claim Sent, Date Claim Rec'd, Amt Billed, Amount Discounted by Insurance company, Amount Paid, Amount Patient Copay.
But then, my boss (The Wife!!!) only sees 6 to 11 patients per day, probably far less patients that what you folks deal with. The average patient she sees for 6 visits, once a week, but she has a few that have been seeing her for years.
Then I have a Daily Schedule Spreadsheet that lists along with the patient's name, their insurance company name, and how much that insurance pays for that specific patient, the CPT code, and the patients copay. The Daily Schedule becomes my bank deposit slip. I try to bill all insurance companies before I go home, and deposit all copays the following day.
I am probably doing double work, but I am comfortable tracking work flow that way.
I am happy with Office Ally, and know most of the features, but I never like to put all of my eggs in one basket, ya know?