Head off problems with early patient education
Head off problems with early patient education
The best way to reduce patients’ misunderstandings about their Medicare statements is to educate them in advance about what service is being provided and how it will be billed, says Vicki Myckowiak, JD, an attorney with Steinberg, O’Connor, & Burns in Detroit.
"It’s important to pre-empt questions, because often when patients get their statements they simply don’t understand what’s going on there," she says. "The wording on the codes doesn’t always correspond exactly to what the physician provided."
When a Medicare patient enters the office, it’s important that there be a patient liaison who understands coding issues to explain clearly what the bill says or is likely to say.
Unfortunately, what often happens is that patients ask questions to staff members who themselves haven’t been educated to understand coding issues.
"Most of the time, misunderstandings arise from coding issues and nothing else," Myckowiak says.
Another way to reduce the potential for problems is to scrutinize coding practices to ensure accurate and well documented coding, she recommends.
"If the codes don’t seem to correspond exactly to what the beneficiary thinks happened, that right away sets their antenna off," she says.
Myckowiak cites the example of a case where coders at a physician practice "unbundled" a particular procedure. Inadvertently, the patient was billed for an injection he never received. That simple error set off a full-blown audit against the group.
But the hard fact is that even if you’ve got your coding under control and have made an effort to educate your patients about the care being provided to them, there’s no guarantee that some patient won’t drop a dime on you.
"Most of the time, beneficiaries have no problem just picking up the phone," Myckowiak says. "After all, they get paid if they turn someone in. And to someone on a fixed income, there can be a real benefit to turning in their doctor."
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