tci Medicare Compliance & Reimbursement - 2015 Issue 8
Part B Revenue Booster: Keep Cash Flow Positive With 10 Tips
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Article Overview
This article covers ten broad strategies for protecting practice cash flow in a Part B setting. It focuses on front-end patient financial processes, insurance and eligibility checks, handling special billing situations, component-based reporting, locum tenens distinctions, nurse visit collection issues, and the importance of diagnosis coding readiness. It is written for practice administrators, billers, coders, and front-desk staff who manage reimbursement workflows.
Why This Topic Matters
The article addresses common sources of preventable denials, missed charges, and delayed collection that can disrupt reimbursement. It helps revenue-cycle teams identify operational areas that affect payment accuracy and claim processing.
Article Sections
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Ten revenue-cycle tips for Part B practices
An overview of operational practices aimed at improving collections, verification, and claim accuracy in outpatient settings. The section frames the article’s focus on cash flow and billing process improvement.
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Front-end patient financial communication and insurance verification
Guidance on collecting patient responsibility information, confirming coverage, and addressing eligibility issues before or at the visit. This section also discusses documentation and communication steps used at check-in and scheduling.
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Special billing situations and component reporting
Discussion of scenarios that affect how services are reported or routed for payment, including facility-related billing distinctions and component-based claim handling. It also covers locum tenens reporting and modifier use in general terms.
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Charge capture, nurse visits, and reimbursement follow-up
A review of practices for comparing logs to charges, assessing billable nurse encounters, and following up when payments are sent incorrectly. The section emphasizes internal controls and collection follow-through.
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Preparing for diagnosis coding changes
A closing segment on the importance of diagnosis coding readiness and the effect of coding accuracy on claim payment. It places ICD-10 preparation in the context of protecting reimbursement.
What You Will Learn
- How front-desk and billing workflows affect collections and claim integrity
- Why insurance eligibility and coverage verification matter for reimbursement
- How special billing scenarios can affect claim routing and payment responsibility
- Why charge reconciliation and documentation review support revenue capture
- How diagnosis coding readiness relates to claim acceptance and payment continuity
Who Should Read This
- Medical practice administrators
- Billing and coding staff
- Front-desk personnel
- Revenue cycle managers
- Physician office staff
Codes Discussed
Modifiers Discussed
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