Monica's Summer Cleaning Tips

The benefits of using a claims scrubbing software can tremendously reduce denial rates, shorten AR cycles and improve cash flow. With some tweaks, adjustments and updates you can maximize the effectiveness of your claims scrubbing software.


Here are my Top 10 Tips to Maximize Your Claims Scrubbing Software:

1. Stay current with the latest version of your claims scrubbing software - you may be missing out on many new enhancements!
   
2. If applicable, perform routine Local or National Coverage Determination (LCD/NCD) updates. Verify with your claims scrubbing vendor how often medical necessity policies are published for your state.


3. Implement routine CPT, ICD-9 and Correct Coding Initiatives (CCI) updates, ensuring CPT/ICD-9 validity.


4. Research if your claims scrubbing vendor publishes reports, training materials, newsletters and/or bulletins relating to application issues and updates.


5. It is crucial to inquire about and apply recommended database maintenance procedures (i.e. purges, size, speed, error messages, etc.) with your claims scrubbing software.


6. Discuss customization capabilities - it is important to create parameters (edits, payer specific rules, etc.) around unusual insurance specifications.


7. Generate and utilize standard and custom system reports regularly to assess and analyze how claims are being processed. These reports can be used to assist in training, education and tracking trends.


8. Consistently review your denials and appeals so that your claims process can become more streamlined. These findings will contribute to improved business decisions and help in modifying your claims scrubbing software.


9. Attend educational sessions offered by other organizations and users of the claims scrubbing software (user groups, conferences, seminars, webinars, etc.).


10. Finally -- never underestimate the power of tapping into your internal knowledge base! Create an internal team to make your claims editing software more efficient and valuable.

End Result = Clean Claims = Priceless!

Monica Stovall, Senior Consultant, Think First
http://www.thinkfirst.us/lower.php?url=monica-stovall