Case Studies
Multi-Location Practice Reclaims Medicare Consult Billings
Every
consult ever billed to Medicare
was denied practice-wide. The staff thought that consults
just were not covered by Medicare. The practice was
missing out on lost revenues, not to mention, the lost time
and effort from staff trying to re-submit the claims.
Quality
Physician Services provided an audit and uncovered several
ways that the practice could recoup reimbursements that were
rightfully theirs, but that had historically been denied.
The most glaring area of concern was the consultation visits.
QPS determined that EOBs lacked certain physician information
that was causing Medicare to reject claims repeatedly.
QPS was able to re-file approximately 50 claims from the past
2 years, and got $7,500 in reimbursements for the practice.
In
order to ensure the practice continue receiving reimbursements,
Quality Physician Services implemented specific procedures
that would survive even beyond staff turn-over. They
utilized their technology background to implement a message
in the client’s practice
management software while posting codes that reminded the user to enter all the information.
They also leveraged a practice intranet,
including links to the UPIN Registry, a daily pre-billing
report and audit and periodic staff training.
The
result is more reimbursements and less time spent on correcting
and re-submitting bills.
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