tci Medicare Compliance & Reimbursement - 2007 Issue 20
PHYSICIANS: Practice 'Concurrent Audits' To Make Sure You're Not Missing Services
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Article Overview
This article explains how physician practices can strengthen revenue capture by improving front-office intake, documentation, coding review, and claim oversight. It is aimed at physicians, coders, and practice managers who want a broad view of revenue-cycle and compliance-related workflow topics, including diagnosis linkage, claim auditing, and administrative systems for identifying eligible services and reporting requirements.
Why This Topic Matters
It helps readers understand why revenue can be lost before and after the visit, and why coordinated front-desk, clinical, and coding processes matter for accurate claims and documentation support.
Article Sections
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Front-desk intake and insurance verification
Covers initial patient-contact workflow, insurance collection, participation checks, and administrative documents gathered at the time of service. It also addresses basic revenue-cycle responsibilities at the front desk.
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Back-end coding and claim review
Discusses coding workflow, diagnosis linkage, and pre-submission review of claims. The section focuses on internal auditing and documentation support in the billing process.
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More revenue booster tips
Summarizes additional practice-revenue topics, including identifying eligible preventive services and tracking documentation for quality-reporting initiatives. It presents broader administrative guidance for physician offices.
What You Will Learn
- How front-desk processes affect reimbursement and claim readiness
- Why internal claim review and documentation checks matter before submission
- How practices can organize administrative workflows around eligible services and reporting programs
- Which broad operational areas support revenue capture in physician offices
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Revenue cycle staff
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