tci Medicare Compliance & Reimbursement - 2013 Issue 17
Revenue Booster: Ensure Your Practice Recoups Deserved Pay With a Well-Oiled Billing and Collections Program
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Article Overview
This article reviews common revenue cycle and Medicare-related billing issues that can affect practice reimbursement. It is aimed at coders, billers, practice managers, and front-office staff who need a broad refresher on claim submission, payer contracting, charge capture, and component-based reporting. The discussion touches on Medicare Advantage considerations, supply billing, facility-versus-professional billing distinctions, and temporary physician coverage arrangements.
Why This Topic Matters
Accurate billing and collections processes help practices reduce missed charges, avoid inappropriate payment reductions, and support cleaner reimbursement workflows. The article is relevant for organizations trying to strengthen documentation, front-desk collection practices, and Medicare claim handling.
Article Sections
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Stay on Top of SNF Patient Status
Discusses billing workflow considerations when patients are associated with skilled nursing facility stays and receive services in other settings.
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Don’t Blindly Accept Sequester Cuts on Advantage Claims
Addresses Medicare Advantage payment adjustments, plan contract considerations, and when claim reductions may warrant review.
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Bill Your Supplies, When Reimbursable
Covers the general treatment of supplies in reimbursement and notes that some supply items may be separately reportable under specific circumstances.
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Cross-Reference Your Practice Log Against A Charge Sheet
Focuses on comparing internal equipment or practice logs with charge capture to identify missed billing opportunities.
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Properly Train Front Desk to Collect Financial Information
Reviews front-desk intake and collection practices, including insurance verification, claim-related documentation, and patient financial responsibility.
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Differentiate PC/TC Components
Explains the importance of distinguishing professional and technical components in reporting services performed with facility equipment.
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Code Locum Tenens Accurately
Covers temporary physician coverage arrangements and the distinction between locum tenens and reciprocal billing scenarios.
What You Will Learn
- How to recognize billing situations involving facility stays and shared billing responsibility
- How Medicare Advantage contract status can affect claim handling
- How to think about supplies that may be separately reportable
- How practice logs and charge sheets can be compared for missed charges
- How front-desk intake supports cleaner financial and insurance data collection
- How professional and technical components are distinguished in reporting
- How temporary physician coverage arrangements are generally documented in billing workflows
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Practice managers
- Front-desk staff
- Physician office administrators
Codes Discussed
Modifiers Discussed
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