Home Forums Discussions General Discussion Problem:We are not sending claims on a daily basis

I need someone's help or suggestion because I am at a lost. We are small Family Practice Office in Wellington, FL. There are two medical doctors and a nurse practioner. In order to submit a claim to our billing company (we outsource), all three providers have to finish there notes so a superbill can be created. We are constantly behind and this has been a problem for the last two years and it is getting worse. The other day i finally finshed exporting the last few days missing in July.

Has anyone had the same issue? This is my first time dealing with an EMR so please forgive me if I sound inexperience. I also want to mention we are new office.


Luis R. Sanchez

We have same issue as well and follow the exact same process of exporting/printing the superbills over to our outsourced biller. Our nurse starts off the note with vitals/weight info and then forwards it on to the physician. We only need to wait for the physician to sign off though so this sounds like only difference (you mention all three must finish to submit a single superbill?)

When our first started using AC, we would get behind if the notes were not signed off. But finishing the notes became an imperative to keep the revenue flowing. We chose not to use a separate out of system superbill as some have done. Thought it would be simpler to just keep it in AC.

Relying on AC superbill hasn't been perfect of course as certain busy times signoffs fall behind but it has worked out well enough to keep revenue flowing.

I suspect that we can all agree that completing notes the same day a patient is seen is ideal. The benefits of that practice are enumerated in other threads. On the other hand, if everyone could do that consistently, we wouldn't be having this discussion. It comes up repeatedly, so no, you are certainly not alone.
The question is how to handle the issue. You can re-double your efforts to complete your notes daily (and you should), but at some point you might want to consider other options. I think we all have enough issues with getting paid promptly that are out of our control, that we shouldn't add to the problem. My suggestion would be to create a separate super bill. As Eric says, it would be nice to keep it all in AC; I have not found a good way to make that work. Perhaps with the PM module it will be easier. We simply have a sheet of paper with common cpt's and diagnoses listed on it. A copy with the patient's name on it goes to the doc at each visit. The cpt and diagnosis are circled by the provider, and they are clipped to a print out of demos and sent to the biller by Fed Ex.
I believe there will be a better way in V6. Call me a crazy optimist.

Paper superbill just as Jon says. If your biller wants it electronically, it's easy to take the stack of superbills at the end of the day that the docs have marked on, scan them to .pdf, and off they go.

That being said, I don't know how many people are in your office but billing is so easy to do. I do all of mine in house and I'm sure I have far more CPT codes and modifiers to use than most PCPs. I was stressed about doing it in the beginning because I was a bit clueless but, man, it's really saved me a lot of money and my collections are so much better. Days in A/R are non-existent. By the end of a clinic day for me, all of the charges have been entered and sent to the Clearinghouse. Takes my office manager an extra 30 minutes per day.

I know that wasn't your question but I think a lot of small practices delegate too much of the work they can do in house to companies who make money doing it for them.

Thank you for quick response and valuable feedback on my issue. To clarify, all three providers have to finish their notes on particular day such as 8/11/10 for example, in order for me to upload all encounters to our billing company. All of my providers seldomly type-in the computer when they are with a patient. Instead, they use the summary sheet and write all of their notes. Later, they inputed in A/C.

Jon, I am sort of glad that we are not the only practive going through this. I've come to the same conclusion as you stated about doing a seperate superbill and that to give to the biller. Let me asking something? Are all EMR's the same way? This is my first time working with an EMR so my knowledge is very limited.

Travis, thank you very much for your valauble feedback aswell. We have three providers, one front desk person and four M.A.'s. Our billing is done by third-party and we are not very pleased with them. How did you do your billing inhouse? I have no idea about clearing houses.

On my original question, I thought about doing exactly what you proposed. Printing out superbills and scanning them to our billing people.

Eric, I forgot to ask you something. You mentioned that your physician signs-off and then a superbill is created. Does this mean the physician has finished his/her note? Can I superbill be created without physician finishing their note.

Luis,

This isn't for everyone but it was for me. I simply went with a practice management program that you can pay for monthly. They provide the clearinghouse, the software, the support, the ability to eligibility checking, electronic remittance advice, everything.

So we started with the software and spent a week learning it. It's $199/month with everything included. That's essentially what I spend on billing every month. There is actually cheaper ones than that. We take the superbills after every day and enter the info (ICD-9 and CPT) and off it goes into some magical land. It returns with an EOB (Explanation of Benefits) and a check.

It was extremely intimidating at first because everyone had always sent it to billers because it was supposedly so difficult. Well, it's not. Not at all. And I know where every claim is, I know it got worked up, sent, paid, not paid, whatever.

You may want to wait for AC's PM system and start with it. You can start slow and only do, say, Medicare claims. Then progress from there until you get the hang of it.

Travis,

I am transitioning to AC from paper charts. I currently use superbills that I send to a third party biller.

What practice management program do you use?

Does the program also have support to manage individual patient accounts and billing. Can it produce practice reports of account receivables or productivity numbers based on cpts or diagnosis?

Thsnks

Richard,
I use CollaborateMD. They use McKesson's clearinghouse. It's worked very well and much better than GE Centricity which is what I used before. It has 50 or so different reports. You can run reports of AR, CPTs, ICD-9s, Deposits, just about every report that I would think you could need. It also will breakdown a report by CPT code and tell you how much insurance company is allowing per CPT code. I also us it as it will tell me how many patients are coming from particular referring providers.

I don't like the format of the patient statements that print out and that is being worked on I'm told.

Their customer service has been quite good for me.

It has it's weaknesses but sending a claim and getting paid is not the weakness.

It has a great ability to upload a customized superbill in .xml format and it puts all the information on the superbill such as amount due, demographics, referring provider, etc.

I think Total MD is another pretty decent PM software for small practices and it has a much more attractive user interface.

There are a ton of PM programs. None of them are perfect as I reviewed numerous and have used several.

Luis- what 3rd party company are you using that you don't like?

Yes, the physician finishes the note and then we do the superbill. If note isn't signed off, we don't do the superbill until note is finished. Not always ideal and if you let notes pile up you will certainly have a problem.

You mention that all notes must be signed for the day before you submit. Based on this, I think you are submitting the bills based on "Encounter Date". You wait until all are done for that "encounter date" and then submit. If this is correct, there is a better way. Pull the data by "Saved Date" rather than "Encounter Date". Very important distinction on these dates and if you pull by saved date you never inadvertently miss and encounter that had a delayed sign off.

Hope this helps!

Sorry the delay. We use MTBC and they outsource to India and the language barrier has been a huge issue. currently looking for another company, will see.

will try, thank you.

Thanks =)