decisionhealth Newsletters, Part B News - 2012 Issue 4 (April)
Keep more revenue by avoiding provider missteps with billing companies
Subscribe or sign in to view the full article.
Article Overview
This article is for practices that use or are considering using a billing company and want to reduce compliance risk, denials, and payment loss. It covers broad oversight topics such as documentation alignment, credentialing and enrollment issues, eligibility checks, incident-to compliance, medical necessity concerns, and monitoring for upcoding or other billing problems. The guidance is aimed at helping practices understand what to review when evaluating a billing partner and how to keep billing activity consistent with the practice’s own records and obligations.
Why This Topic Matters
Billing-company errors can create denials, overpayments, audit exposure, and reimbursement losses that still fall back on the practice. Understanding the main risk areas helps leaders supervise outsourced billing more effectively.
Article Sections
-
Compliance
Introduces the role of billing companies and the compliance risks practices face when outsourcing billing functions. Discusses common oversight areas that can affect revenue and audit exposure.
What You Will Learn
- Why practices still remain responsible for billing-company errors
- What general areas to review when supervising an outside billing company
- How documentation, eligibility, credentialing, and submission practices can affect compliance
- Why monitoring for potentially problematic billing patterns matters
- What kinds of oversight can help reduce denials and audit risk
Who Should Read This
- Physician practices
- Practice managers
- Revenue cycle managers
- Billing supervisors
- Coders
- Compliance staff
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com