centricity cps - techniques to effectively manage accounts receivable - chug 2014
DESCRIPTION
The presentation will begin with how to identify aging balances in Centricity. Then it covers streamlining claim workflow to work smarter not harder. We'll review troubleshooting claims that have been filed with no payment received and how to track down those claims. Discuss methods to improve accountability through documentation best practices. Gain a better understanding of visit status and the claim lifecycle. Finally, we will discuss Centricity AR reports that will also help in managing AR. Objectives: •Actively identify and sort Aging and problem visits by reviewing the Billing window with specified Status and Date range criteria to easily identify issues •Learn documentation best practices by identifying the cause of the rejections/aging visits and establishing a standard for storing notes and current visit status. •Identify some of the core Accounts Receivable reports that will allow for an administrative view of the ongoing success of the AR process.TRANSCRIPT
Techniques to Effectively Manage
Accounts ReceivableKirk Fahlberg – Unlimited SystemsTwitter = @kirkfahlberg
Purpose• Learn how to efficiently &
effectively manage Accounts Receivable in Centricity.
Benefits• Increase efficiency using an
interactive workflow
• Identify aging balances
• Improve accountability through documentation best practices
Agenda• Centricity AR Reports
– Benefits & Disadvantages
• Active AR -Workflow Efficiency– Identify issues through Billing searches
• Troubleshoot Claims• Documentation Best Practices
– Visit Description, Billing & Correspondence Notes
• Understanding Visit Status– Lifecycle, Visit Status & Activity Log
Accounts Receivable
Reports
AR Reports-Common• Accounts Receivable
– Aging by…– Procedure Date Aging– Outstanding Insurance– Credit Balance
• Collections Folder– Account Balances– Insurance Delinquency
• Administrative Folder– *Correspondence Audit Report
AR Reports-Administrative
• Correspondence Audit Report– Run by Patient, Provider or
User
AR Reports-Define• F1 to learn more about a report
AR Report-Benefits• Check “the Pulse” of AR • Identify problematic carriers• Administrative scorecard
AR Reports-Disadvantage• Doesn’t drive efficient
agent workflow– Paper reports become checklists
• Worked from top to bottom– Unable to group denials &
recurring issues
• Limited Feedback– Notes are frequently stored
externally & only known by the agent.
Active Accounts Receivable
Active AR-Billing Screen• Efficiency
starts in the Billing component– Date– Status - Not Paid or
others.– Insurance Group– Minimum Visit Ins.
Balance
Active AR-Review Status
Active AR-Audit Status• Worksheet to Audit Billing Visit
Statuses…– CHUG Forums
• Centricityusers.com• Forums• The Trading Post• Training Materials
Active AR-Audit Example• 22 Provider Practice
Active AR-Task Mgmt.• Build out queues to review
Statuses
http://cpstraining-gehc.com/joomla/Docs/cps10/13_CPS_PM_10_Task_ManagementCompanionGuide.pdf
Active AR-Billing Results• Is something missing?• How can this be more effective?
Active AR-Order Columns• Recommended Columns
• Right Click on a Column Header - choose Columns, update & save
Active AR-Sort Columns• Organize and Group items
Active AR-Group Issues
• Recommended Sorting– Visit Date - Check for “Timely Filing”– Visit Insurance Balance - Work highest
dollar– Last Filed - How long was it “out to
the carrier”
• Group issues to “Work Smarter, Not Harder”– Approval Results - Failed or Rejections– Patient, Doctor, Company, Facility, or
Insurance issues– Visit Description - Mile High View
• Use two windows - Billing & AR
Active AR-Drill Down
Troubleshoot Visits
Troubleshoot-Review Notes
• Visit Description - Short story• CPS – Approval or Batch rejects• Visit Billing Notes – Int.
messages
Troubleshoot-Corr. Tab• Permanent log of interaction
– Rejections, carrier or patient related AR notes
Troubleshoot-Claims Tab• Filing History
– Reorder columns headers for efficiency
• Clearinghouse & carrier responses– Limited error length– Shows reports that
affect the status of the visit.
Troubleshoot-Responses• EDI Response
Management– File Name - Blank or
type– Date Received -
• From: Date visit was sent.
• To: Leave blank– Search for files...
• Enter Ticket, Error or text
– Check “Include Archived”
Troubleshoot-EDI Reports
• Right Click on the report & choose View
Troubleshoot-Find Denials
• Click Edit - Find (CTRL+F) - enter Ticket, Error or text– NOTE: May be more than one entry in the
report file.
Troubleshoot-Note Errors• If denial is clear, correct &
refile• Note & research unknown
errors– Search Internet
• Google– Carriers Website– Contact Support
Documentation
Documentation-Description
• Mile High Claim Summary– “Three Legged Stool” - Status + Description +
Owner– Enter brief status message with date & initials
• Example: 50 J0885 - 03/20/14 KF”– Located: Payment Entry & on the Visit Screens
Documentation-Visit Note• Visit Note - Tell the short story
– Modifiable Notes for questions or reasons• Example: Refunds, adjustments, or
recoupment.– Located: Notes Tab & Transaction Distribution
Window• Double Click to add & see more information
Documentation-Corr. Note
• Correspondence Note - Detailed Story– Permanent log of troubleshooting– Located: Corr. Tab
Visit Status
Visit Status-Lifecycle• Automated Status
progression– Visit only change to the
expected next status• Example - Visit on Hold,
receives the last payment, it will not go to Paid unless manually changed
Visit Status-Definitions
Visit Status-Definitions
Visit Status-Manual
• These should only be changed if confident in the status change & office workflow– Other Status Examples: Refund, Refile & Bad Debt
Visit Status-Unexplained
• Visit Activity Log – May explain an
unexpected Status– Example: moved from
Paid to File Rejected– Bill Code & Status
Questions?
Thank you for attending!