Cleaning Up Your Billing Claims For Better Results

I read an article in Medical Economics- August 15, 2008 issue-that was written by a practitioner in a large ob/gyn practice in Philadelphia. The practitioner mostly focused on the importance of clean medical claims with good coding techniques.

I felt compelled to respond to the article with the following letter:

“I enjoyed the article by David M, Jaspan, D.O. That I have written over and over in my head as well as lectured to offices for which I consult and bill. As a billing service and managed care consultant, (self-employed) I have often found myself between the insurance company and the doctor. While it is true that some plans are more doctor friendly than others, it is also true that the insurance companies are not always the worst enemy we have. I continuously stress to my clients and their staffs that they are the first ones touching the superbill, charge slip, routing slip, encounter form. The cleaner it is, the more advanced it is in using modifiers and trying some add-on codes that are clearly described in a CPT book/computer program the better the chance to see an improved cash flow. I also try to stress that correct is better than quick, having seen my share of superbills prepared that are sloppy and incomplete in the doctor’s haste to just get them our the door to me to do the billing from my off-site location”

After 14 years in this business on my own where I rely on a salary based on the doctor’s receipts I have no choice but to employ strict policies for myself as well as the offices with whom I have enjoyed long term relationships. And when you call insurance companies as much as I do, it helps to know what I am talking about regarding clean claims.

Fran Glucroft
Medical Office Manager
Fairfield, CT