Chiropractic documentation gap analysis

Recognize what’s missing to master your reimbursement and collections!

This Documentation Gap Analysis allows us to evaluate the significant components of your current Documentation program. It should take less than 5 minutes to complete.

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Sometimes you need more than a self-service, on-demand program and need an expert to analyze your issues, train the corrections, and help you implement the changes, so they stick

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This course explains the significant role chiropractic care can play in the sports industry and how a DC can succeed as a Sports Chiropractor. Start your steps to success here!

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The most effective chiropractic OIG compliance programs are scaled according to the size of the practice!

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Master the Use of Your A/R Aging Report

You Must Beat the Bushes

Proactive aging calls are calls that are generated when we notice an outstanding balance on our aging report and have no idea why it’s there. They are generally calls that will review all outstanding bills or dates of service, and we need to call the carrier to determine where the payment is and why we haven’t received it yet.

Most practice management software systems use an aging report to identify balances and the length of time that they’ve been due. Their procedure is to automatically move outstanding balances to 30, 60, 90, or 120 days. Alternatively, this takes place when you process your end-of-the-month procedures by computer. Either way, it’s important to stay on top of these balances so that you can be aware of the average age of each balance for not only each patient in your system, but for each payer class.

We recommend that you print out your aging report by payer class. This means that you will individually print all the Medicare, all the Blue Cross Blue Shield, other commercial carriers, personal injury, workers compensation, cash patients, etc., separately. If possible, you want to order these print-outs with the highest balances first, rather than in alphabetical order. It’s important to work the most productive balances first, especially if you’re just beginning an aging report procedure. If it’s not possible to sort by balance, it’s helpful to print out by insurance carrier. This way, when you’re on the phone working with that carrier, you’ll be able to follow up on more than one patient at the same time. Be sure to only print out aging report balances that are at least 30 days old. Not only will this make that aging report much more manageable, you’ll also save time by not dealing with bills that are most likely not yet ready to be paid.

Separate your aging reports either in individual three-ring binders or by tabs by payer class in one large binder. Each month when you print a new aging report, put the that new month’s report on top of the old one. This way, you can refer back and see your progress. This also makes it easy for doctors or office managers to review aging reports on a monthly basis.

Dedicated Time Is a Must

As you’re making phone calls, make sure to look at all outstanding bills for the patient in the computer system. Once you’ve received information about each outstanding bill, make brief notes on the aging report, make detailed notes in your internal financial notes, and then take action as needed. If no action is needed on an aging report item, simply mark an X through it and move on.  If you have completed action on an item, mark it as complete and move on.

Try to work through an aging report within a month’s time, at a minimum. If you haven’t been making proactive calls, the first couple of months may take longer. The most important thing: take action on each item. If you find a balance is due from a patient, don’t just skip over it; make sure that the patient’s balance is accurate, figure out if they have for some reason not been getting statements or whether they’re getting statements and simply not paying the balance, and then bring it to the front desk team members’ attention so it can be handled.

Here’s our recommended procedure for proactive aging report phone calls:

  1. Review the insurance information in the computer. Get the appropriate phone number, claim number, ID number, and other pertinent information to begin a call.
  2. Call the insurance company and let them know you’re calling to check the status of an unpaid bill. They will usually want to know the insured’s name, patient’s name, dates of service in question, etc. Make sure you’re prepared with this information.
  3. While you have the adjuster or customer service representative on the phone, follow up on all outstanding bills and claims.
  4. Whatever action items are necessary, complete them, make notes on the internal financial record, and be sure to list any ticklers in your reminder file.
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Being a member of the KMC University is a valuable resource for our office. We appreciate that they are on top of the most current information. The Staff is always pleasant and quick to answer our questions.

Edwin S.