Try these home care best billing practices

Everyone has his own way of working. Some ways are better than others, but they are usually subjective. Not so when it comes to financial-related matters, especially those to do with billing.

One mistake can be extremely costly; two can be fatal to an agency’s profit structure. Betsy Drennan, reimbursement manager for VIP Home Care in Amarillo, TX, has several tips to help ensure your agency doesn’t fall victim to "death by erroneous billing."

1. As soon as the patient is admitted, always verify Medicare benefits and beneficiary information using the HIQA system through Advantis, Passport, INET, or any other on-line claims system that other fiscal intermediaries use.

2. Always have the patient sign a service agreement stating that the patient will be responsible for any charges that Medicare will not pay and for which the patient has been notified.

3. Develop a regular billing cycle and try to bill as soon as possible after the billing period has closed.

4. Get a software program that allows you to run many reports during the patient’s stay on services to ensure that all documentation that is needed for billing is in place. Examples of such reports include missed visit reports, orders outstanding reports, and a log/scheduled/ordered difference report that shows whether a visit had been logged in and is inconsistent with either scheduling or any orders that were logged into the system.

5. Always run absent data reports, orders outstanding reports, and missed visit reports on the day of billing. Any patient who appears in these reports should be "held" until the items are cleared.

6. Make sure your billing department is running regular aging reports and posting payments daily. This procedure will ensure that any denials or corrections, etc. are caught daily and will be more effective than doing a lot of research at the end of each month to determine where the mistake was made.

7. When your billing department runs an aging report (running one every week is suggested), write in the reason that any balance is outstanding 30 or more days. This will help to remind you of the reason as well as help keep your management staff informed of the case’s status.

8. Perform semiannual audits. Audit all billing files to ensure that each piece of required documentation is in them. Then list the patients who were on services and the dates of services, and make certain their claims are on-line. Rerun bills on all patients and make sure that they match those originally sent out so you can be certain that no adjustments need to be made. Check to see if your billing software will let you run a short report, which will tell you when visits have been added to the system after billing was completed.

9. All reimbursement managers and billers should view the claim count summary of Advantis/INET, etc. on a daily basis to get a quick overview of all their claims and their particular status.

10. Remember that in Texas, private-pay patients must be billed the same amount that you bill Medicare for services. (What you collect is optional, but the patient’s bill must match that of Medicare.)

11. Hold frequent inservices with clerical staff to keep them updated on new regulations, etc., and to review any problems that you have noticed. Keep a log of corrections and review them with the office manager on a monthly basis. During this time, you can offer suggestions on how to prevent these same corrections from being made in the future. n

Betsy Drennan, Reimbursement Manager, VIP Home Care, 1619 S. Kentucky St., Suite D1330, Amarillo, TX 79102. Telephone: (806) 355-9191.