December 3rd, 2015
By: Debra Sanders (Mar/22/2013)
When working my AR, I work my surgeries separately since that is my big money or bulk money. I want to make sure I get that money in as quickly as possible. For me, I created an excel spreadsheet. The columns are: DOS - PATIENT NAME/MRN - PROC NAME - CARRIER(S) - CPT® - MODIFIER - BILLED - PRIMARY PD - SECONDARY PD - ADJUSTMENT - PERSONAL BAL - TODAYS DATE - COMMENTS. I also color code my spreadsheet.
After I enter my surgeries in the system, I then pull up my spreadsheet and enter them on that by line item and auto sum each. I highlight it a dim yellow. This means I'm waiting for the insurance to pay. Light blue means primary paid and I'm waiting on the secondary to pay. Bright green means I appealed something. And tan means the insurance(s) have paid. I don't work my personal balances off this spreadsheet because I work those off of the personal balance report to keep it simple. When I work my spreadsheet, I enter the date I'm working it and any comments to reflect my work along with the reimbursement information when it pays.
Each month I am able to email my providers so they know what I'm doing with their surgeries and how I'm working to get them paid. Plus color coding makes it easy to work. I work all the yellows first, blues second and I have my appeals on my calendar to follow-up on. The tans I can just skip because that means the insurance(s) have paid correctly. I don't delete any until the following year. Once I have all the previous years done, I will then delete those so I don't end up with 1000 pages.
Now when I work my regular AR report, if I come across a surgery I will take a look at it and work it if I need to, if I see I've already worked it I move on. Not only has this been helpful in keeping me accountable and "owning" my AR, but it has helped in maintaining a good follow-up on them as well.
Even if you just write them in a book, or maybe a ledger of some kind. Either way, don't loose track of your follow-up on your big money. It not only shows you your reimbursement on them, any contract processing errors made in paying you, but it helps to keep that big money coming in a lot quicker. So pick your method and stay on top of those surgeries as well as keeping your provider informed. Sometimes you both can even learn something from a coding change or reimbursement issue by keeping at least your surgeries separate.