On this episode, I sit down with Teri Thurston, PECAA's Billing & Coding Advisor to discuss the biggest issues practices face with their billing and coding processes and how to fix them. 

Key Takeaways:

1. Start at the beginning - with insurance verification. Verifying the patient's insurance ahead of time informs the practice on how to best care for the patient and leverage those benefits before the patient steps foot in the practice. 
2. Evaluate the entire Revenue Cycle Management process. Determine the areas that need work and define those individual steps and processes in specific detail. Make sure they work for your individual business. These established processes also help when you have to replace or fill in for your billing specialist.
3. Under-coding and over-coding are significant problems. Take the time to learn what you can bill, how to determine the exam levels you provide, and the appropriate documentation. Don't miss out on billing for services you provided as they are also risky in an audit. Knowing the rules helps you sleep at night when it comes to an audit. 
4. Medical and vision insurance can cause challenges when the patient presents for a vision exam, yet has a medical problem. Leverage both within the rules and keep medical and vision separate when appropriate. Educate your patients up front and throughout their entire experience with the whole team.
5. Don't forget the processes after the patient is seen. Submit claims on time. Chase down denials and rejections as soon as possible. Track and manage your billing and coding KPI's. 

What Teri is reading:

• Atlas of the Heart by Brené Brown