Best Practices for Billing Out Medicare Claims

by Applied Medical Systems

If your healthcare organization accepts Medicare, your goal should be to accurately and efficiently process Medicare claims. This way, you can ensure you get paid for the services you have provided your Medicare clients in a timely fashion. Here are some of the best practices for Medicare billing: Stay on Top of Changes Medical billers should be up-to-date on any changes related to Medicare. They can do this by subscribing to Medicare related newsletters, attending conferences, and/or participating in continuing education classes. File Claims on Time Perhaps one of the most important best practices is to file claims on time. The Affordable Care Act has reduced the claims submittal period from between 15 and 27 months to 12 months. The only exceptions to this period are administrative error, retroactive Medicare entitlement involving state Medicaid agencies from a Medicare Advantage Plan or Program of All Inclusive Care of the Elderly (PACE) Provider Organization. Failing to adhere to the Medicare timing guidelines may lead to denials. Take Advantage of Technology There are a variety of cutting-edge technologies that can help with Medicare billing. These technologies may include automated payment reminder messages with mobile or online payment options and integrated reports that will show how much revenue a Medicare provider is waiting on. Avoid Upcoding Using a higher paying code on a claim in order to receive a higher reimbursement is referred to upcoding. Upcoding is illegal and should not be performed by a Medicare provider in an attempt to collect more money that they have earned. Make Denials a Priority It can be time consuming to work Medicare denials. However, doing so is an important step of Medicare billing as it allows providers to determine whether certain denials could have been prevented. Edits to the claim should then occur in an EHR and patients should only be involved if necessary. Ensure All Charges are Captured In order to make sure they do not miss collecting any payments, Medicare providers need to document all charges. Codes should be reviewed by a coding specialist and all charges should be captured in the EHR. Analyze Reimbursements Organizations that accept Medicare often assume they are finished after they have been paid. To ensure they are compensated properly for their time and services, they should analyze their average Medicare reimbursements to find out if they are profiting. Contact Applied Medical Systems The medical billers at Applied Medical Systems are experts in billing out Medicare claims. If you are a Medicare provider who would like to streamline your billing process and maximize reimbursements, contact us today to learn about our Medicare billing services.