Are You Ready for 2010

The end of the year is approaching fast. There are many things that need to be done as the new year is welcomed in to prevent your office from losing money. It is best to be ahead of the game to prevent revenue loss. If you plan ahead and organize, you can breeze into the new year with smooth sailing.

One thing that needs to be done before the first of the year is authorization switches. If you are in an office that requires authorization for your services you may have to have the authorizations moved over to the new year. Many carriers have the authorizations end on December 31st of the current year. There may still be unused visits, but the authorization must be moved into the new year. If you are an office that deals with authorizations, make sure your auths are in order for the new year. If you bill for providers who deal with authorizations you may want to remind them to make sure their auths are in order.

There are also many insurance carriers who base their timely filing on the end of the year. For example, one of the larger carriers in our area has a timely filing limit of March 31st for all claims for services in the previous year. If you have carriers with this type of timely filing rule then it is important to do the followup on any outstanding claims. Don’t wait until March 29th. That is too late. It seems like a no brainer, but you wouldn’t believe how many offices lose money to timely filing. Followup should be done regularly all year long, but if you have a carrier that you know has a timely filing limit based on the end of the year you should plan for it. If you do the followup in early January you will leave yourself plenty of time to check them again and resubmit if necessary before the limit.

Whether timely filing is an issue or not, it is good practice to clean up any outstanding claims from the previous year as quickly as possible. There is a better chance of having the most favorable outcome on a claim, which for most of us is payment, when the claim is processed as soon as possible after the services were provided. Claims left to drag on and on into the next year are not as likely to be paid.

We like to go through the office in December and see if we need to make any changes. We review our filing needs to reorganize our files. As we grow, so does our need to file information received from our providers. December is the month we like to clean out our file cabinets and move information no longer needed into storage. We like to step back and look around and see if in our haste to get our work completed we have overlooked things that could simplify our work.

Many of us set New Year resolutions with grand plans of all the things we would like to accomplish in the next 12 months. It’s a good idea to review last year’s resolutions to see if you have been realistic in your planning. Don’t just make these resolutions, but make a plan to implement them.

Of course, we must consider that tax time is quickly approaching and it’s a good idea to organize your records to prepare for income tax filing. It is good to have systems in place for dealing with end of the year issues. It will make the process of transitioning into the new year much easier.


Medical Billing

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2 Responses to “Are You Ready for 2010”

  1. Lorie Howard Says:

    Hi, Solutions Medical Billing/Alice 1/27/10

    What do I need to become HIPPA compliant? My software is HIPPA compliant. Do I need a certificate from Medicare in a test on line for this? I am trying to get all the important information in order to start my billing business. Do you have a contract that you sell to new medical billing businesses that both the provider and myself will sign? Please let me know.
    Thanks so much for all your help. I enjoy your books very much.

    Lorie Howard
    Professional Medical Billing/Consulting
    236 Spencer Street
    Folsom, Ca 95630
    1 916 353 0300 Wo
    1 916 985 7115 Ho

    • solutionsmedicalbilling Says:

      To be HIPAA compliant you must make sure that all of your business activities abide by the HIPAA rules. There is no certificate or test. You must follow all HIPAA rules. There are no ‘HIPAA police’, they only investigate if a complaint is filed.

      We do not have a contract that we sell, but we are working on a book to help people understand what needs to be in a contract. Contracts are legal documents and you really need a lawyer to do the final draft. However, you need to know what you need in there for the lawyer to do that.

      Michele

      HIPAA Information


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