How Can Physician Practices Prevent Overpayments?

Coding and billing is an essential part of any physician practice and it requires expertise.

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Physician practices are always concerned about upcoding, overbilling and underbilling. How can you make sure your practice doesn’t have billing issues?

First, make sure your compliance plan is up to date. Your employees should be trained regularly. Your compliance program should allow for all employees to be able to report concerns anonymously, so that you are made aware of potential billing issues quickly. It’s often the case that employees are aware of issues before physicians, and they must have the ability to raise them.

Take your employees concerns seriously and conduct a full investigation when issues are raised.

Next, make sure that you understand a payer’s requirements before submitting any claims. Work with your providers to ensure timely and accurate payment.

You should also be regularly monitoring all coding and billing. If you find something strange during your regular monitoring, it is time to perform an audit.

Regular audits are required, but can and should be performed as necessary when issues arise from routine monitoring. Consider whether your practice would benefit from an internal or external audit.

Rickard & Associates helps clients with external audits, while utilizing attorney-client privilege to protect results while addressing and correcting potential issues. Rickard & Associates also provides training to get your billing back on track.

Make sure that you train all new staff and providers on billing and compliance when they are hired. Audit all of their coding and billing for a period of time until you are comfortable that they are billing and coding accurately.

If you have questions, ask an expert.

Let us know how you keep your billing and coding accurate by commenting below!

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