Practice Management

What is Practice Management?

Practice Management includes the following services:

Verifying patient eligibility and benefits.

Gathering and entering of patient demographics into your practice management

Making sure the appropriate CPT and ICD-9 diagnosis codes correspond.

Being certain that the procedure codes that are supplied by your client are not

part of a CCI edit.

Making sure applicable managed care authorizations and/or referrals are on file for the services performed.

Batching and transmitting your claims to a clearinghouse is the more efficient means of transmission.

Providing follow-up on unpaid claims and outstanding patient balances.

Filing claim appeals when necessary.

Providing Secondary and Tertiary claim submission when applicable.

Posting patient and insurance payments to claims/accounts.

Sending patient statements and, when necessary, letters for soft collections.

Providing your client(s) with accurate monthly reporting on all of the above.

Staying educated and on top of Industry Standards with HIPAA and OIG compliance, as well as Medicare, and State/Local regulations

1 comment:

Lucas said...

Thanks so much for the post. I have a buddy who's in medical practice management and I had no idea that they are supposed to provide clients with everything of that they can file claim appeals. I'm gonna have to get after him a little.

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