Protect the Clinic’s Reimbursement The Accounts Receivable process often requires the workforce member responsible for billing to follow up on denied claims or recoupment requests. If your team member is using the KMC University follow up system, these are located in the Reactive Follow Up file. As a compliance officer, it is vital that you…
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A Closer Look at the Results Now it is time to review the numbers. There are several guidelines you can follow to see how your ratios compare to other national averages. It’s important to understand that these are guidelines, and we are not recommending ways to fool the insurance companies or increase reimbursements. The report…
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Now it is time to find your quiet place and ready the tools and documents you downloaded. Follow along in this step-by-step tutorial on how to use the Coding Tool to audit your coding process. You may want to download the Sample Audit Tool as you complete the training. Be sure not to confuse your…
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KMC University has lessened the frustration of the audit process by creating customized Audit Tools to streamline the auditing process. The coding audit tool was created to identify coding practices that might be a red flag to external parties. Get Ready to Audit Prior to viewing the How To tutorial, we recommend that you locate…
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The Patient’s Story To someone on the street, a claim form may just look like a bunch of numbers. However, for medical professionals and, more importantly, insurance payers, it tells a story about the patient. As payers and coding authorities evaluate procedure codes, diagnoses, and reimbursement yearly, they are often looking for fraudulent behavior among…
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Is your practice on the right track? Some clinics base their coding success on paid claims only to find themselves in a full audit that includes a take-back request from the insurance company dating back over two years in paid claims. This is a risky approach and can sink a practice. Investing time in self-audits…
Oops, your level of membership doesn’t include access to these advanced materials. They are reserved for members working directly with our OIG compliance specialists. Please reach out to the HelpDesk to learn more about accessing these materials.
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