Medical Billing - DME Software Item Inventory

In this installment of medical billing and DME software, we're going to cover the topic of item inventory. We're going to explain how the inventory functions work, what information inventory tables contain and how this all ties in with the medical billing of a claim.

Item inventory is a very large part of the DME system. Because DME billing is for durable medical equipment, thus the name DME, a lot of items get dispensed to the patient. These items range from small things like test strips for diabetics, to large items like wheelchairs, beds and oxygen concentrators. Some of these items are sold and some are rented. There alone lies a big distinction and the reason why the inventory tables have to be broken up into what are called purchased items and serialized items. Purchase items are pretty well self explanatory, but some explanation is needed for why rental items are referred to as serialized items.

Rental items are referred to as serialized items because each item that is rented has a unique serial number attached to it. This serial number is tracked for the purposes of billing monthly rentals, which is usually how either the patient or insurance company pays for these items. If a rental item has to be replaced because it is defective or broken, then a new item has to be issued and its serial number noted for future billing. The old item is then put back in inventory and either fixed or thrown away and deleted from inventory.

The information that is contained in inventory is more than what most people realize. It is more than just the description of the item. For purchase items, it includes how many of the items are in stock, how many sales of the item were made, so that companies can track how well an item performs, reorder points so that they don't run out and a number of other things. For rental items, the information includes when the item was rented, how many months of billing have occurred, when the item is scheduled for maintenance and a host of other items. Most normal inventory records contain anywhere from 30 to 100 fields depending on how much information the company wants to track and the capability of the software itself.

How does this all tie in with medical billing? Well, the biller has to know how each item needs to be billed. So for starters, they have to know if it is a rental or purchase item. They have to know the price of the item. They have to know when maintenance is due on a rental item so they can send a bill for that maintenance. They have to know when an item is low so that they can notify inventory, just in case they're not aware of it, which they should be. If a biller has to replace an item, they have to know what replacement items are available. The list of things that a medical biller needs in relation to inventory is endless.

Without item inventory tables, the medical billing process would be a total nightmare because billers wouldn't know where anything was, what it cost and if it was even in stock.

Michael Russell Your Independent guide to Medical Billing

4-Step Training Video for Chiropractic Office Billing Software and Compliant SOAP Notes

Chiropractic office billing software has become mission critical component for chiropractic office profitability and post-payments audit risk management. Practice management systems automate most clinic operation activities, starting with patient check in, SOAP note editing, insurance claim creation, and medical billing.

Unfortunately, the high level of computer skill required by the prohibitively complex chiropractic office management solutions often hinders the doctor's ability to use such solutions correctly, especially for compliant visit documentation and billing. Instead of increasing office productivity and efficiency, technology becomes yet an additional obstacle and profitability impediment. Its high cost and user training problems add insult to injury and frustrate even seasoned and accomplished practice owners.

Since insufficient notes are the most frequent reason for failing a post-payment insurance audit, timely filing of compliant SOAP notes and submission of congruent insurance claims are the most mission critical parts of any practice management automation solution. But SOAP notes and insurance billing are also the most complex parts of such solutions, often confusing doctors and assisting personnel and degrading practice profitability. The ability to manage compliant notes in minimal time without delaying the patient flow is especially important in a high-volume practice environment.

Component-driven SOAP notes are both audit-proof compliant and require minimal time spent for visit documentation. Chiropractors using Vericle's SOAP notes, receive a training video, which has two parts. The first video trains chiropractors taking SOAP notes during the initial visit and the second – during subsequent visits. The training video follows a four-step outline:

1. Systems menu selection to access patient SOAP notes from Appointment Scheduler
2. Date and Doctor selection
3. Component-driven narrative creation for accelerated and compliant editing:
   1. Patient has Subjective complaints
   2. Objective tests show problems that support patient's complaints
   3. Activities and Daily Living of the patients suffer because of same complaints, which are confirmed by objective tests
   4. Show diagnosis Assessment isolating the problem for treatment
   5. Comprehensive Plan shows specific actions with measurable improvement objectives including starting time, treatment duration, and expected benefit.
4. Subsequent visit documentation - select existing SOAP note components for change:
   1. Few individual notes can be the same or even show occasional exacerbation
   2. Overall the series of notes demonstrate a trend of improvement across Subjective complaints, Objective tests, and ADLs
   3. Assessment and Plan often stay the same until re-exam

Chiropractors using Vericle system have access to the training video directly from any screen on the system using a special-purpose Wiki (shared knowledge repository on the Web). Combining Wiki with video technology solve many of the difficult training problems of chiropractic office owners and managers for compliant visit documentation and billing. Such combined training solution amplifies the advantages of individual training video materials with Wiki's ability to reach every chiropractic office, share experience of real-world experts, and help practice owners and managers stay smart at their pace and on just the content they need to know. The “on-demand” nature of an integrated solution enables doctors to learn from experts wherever and whenever it is most convenient to learn.

Yuval Lirov, PhD, author of "Practicing Profitability - Network Effect for Revenue Cycle Control in Healthcare Clinic and Chiropractic Office: Scheduling, SOAP Notes, Care Plans, Coding, Billing, Collections, and Audit Risk" (Affinity Billing) and "Mission Critical Systems Management" (Prentice Hall), inventor of patents in Artificial Intelligence and Computer Security, and CEO of Vericle.net - Distributed Billing and Practice Management Technologies. Yuval invites you to register to the next webinar on audit risk at BillingPrecision.com.

4 Step Denial Management To Improve Performance Of Electronic Medical Billing Software And Service

Partial denials cause the average medical practice lose as much as 11% of its revenue. Denial management is difficult because of complexity of denial causes, payer variety, and claim volume. Systematic denial management requires measurement, early claim validation, comprehensive monitoring, and custom appeal process tracking.

In a high-volume clinic, the only practical way to manage denials is to use computer technology and follow a four-step procedure:

 

1. Prevent mistakes during claim submission. This can be accomplished with a built-in claim validation procedure including payer-specific tests. Such tests ("pre-submission scrubbing") compare every claim with Correct Coding Initiative (CCI) regulations, diligently review modifiers used to differentiate between procedures on the same claim, and compare charged amount with allowed amount according to previous experience or contract to avoid undercharging.

    

    

2. Identify underpayments. Underpayment identification involves comparison of payment with allowed amount, identification of zero-paid items, and evaluation of payment timeliness. The results of this stage should be displayed in a comprehensive underpayment report sorted by payer, provider, claim identification, and the amount of underpayment.

    

    

3. Appeal denials. Appeal management includes appeal prioritization, preparation of arguments and documentation, tracking, and escalation. Note that CCI spells out bundling standards but the number of standard interpretations grows in step with number of payers. Therefore, CCI provides justification basis for an appeal and every appeal must be argued on its own merits, including medical notes. Denial appeal process is typically managed with a custom process tracking system, such as TrackLogix.

    

    

4. Measure denial rates. "You cannot manage what you do not measure." By measuring denial rates and observing payment trends, you can see if your process requires modifications.

    

    

 

Denial risk is not uniform across all claims. Certain classes of claims run significantly higher denial risk, depending on claim complexity, temporary constraints, and payer idiosyncrasies:

 

1. Claim complexity
   1. Modifiers
   2. Multiple line items

    

    

2. Temporary constraints
   1. Patient Constraint, e.g., claim submission during global periods
   2. Payer Constraint, e.g., claim submission timing proximity to fiscal year start
   3. Procedure Constraint, e.g., experimental services

    

    

3. Payer idiosyncrasies
   1. Bundled services
   2. Disputed medical necessity

    

    

 

First, for complex claims, most payers pay full amount for one line item but only a percentage of the remaining items. This payment approach creates two opportunities for underpayment:

 

1. The order of paid items
2. Payment percentage of remaining items

    

    

 

Next, temporary constraints often cause payment errors because misapplication of constraints. For instance, claims submitted during the global period for services unrelated to global period are often denied. Similar mistakes may occur at the start of the fiscal year because of misapplication of rules for deductibles or outdated fee schedules.

Finally, payers often vary in their interpretations of Correct Coding Initiative (CCI) bundling rules or coverage of certain services. Developing sensitivity to such idiosyncrasies is key for full and timely payments.

Powerful Vericle-like technology helps manage denial appeals nationwide and stay current until complete problem resolution. Every time one billing problem is solved, the newly gained knowledge is encoded for recycling. Sharing billing expertise in a central billing knowledge base expedites future problem resolution.

Yuval Lirov, PhD, author of "Practicing Profitability - Network Effect for Revenue Cycle Control in Healthcare Clinic and Chiropractic Office: Scheduling, SOAP Care Plans, Coding, Billing, Collections, and Audit Risk" (Affinity Billing) and "Mission Critical Systems Management" (Prentice Hall), inventor of patents in Artificial Intelligence and Computer Security, and CEO of Vericle.net - Distributed Billing and Practice Management Technologies. Yuval invites you to register to the next webinar on audit risk at BillingPrecision.com.

User Friendly Medical Billing Software

Medical billing software is easier to use today than ever before. Innovations in the technology of medical billing software have created a new touchstone of digital accuracy. Once a complicated text-based interface filled with awkward textual fragments, today's electronic medical billing suites are slick, undemanding, and intuitive, finally generating documents your patients can easily understand.

No more complicated invoices in the mail. Now easy medical billing software offers complete billing summaries. All you need to get there is the aid of a medical billing program that includes software that tracks claims management, patient billing, insurance, and scheduling in a single package. Easy medical billing software can create a seamless workspace in which everything from electronic medical records to healthcare forms is integrated and simple to use. Now you can find opportunities that allow you to effortlessly configure software yourself. Some other important features worth noting are; easy access to the latest forms and guidelines, a step-by-step process that will prompt you through the programs many functions, and an automatic bill printing feature, that will reliably generate the correct documents.

Many easy medical billing software packages are now designed like the paper scheduling and hard copy claims processing with which you are familiar. This software model makes learning fast and easy, even for first-time users. When investigating the different possibilities of medical billing software, it is a good idea to verify that the system was designed for the safe and secure back up of data and is HIPAA compliant, and whether the software is easy enough for a computer novice and will, at the same time, meet the needs of a busy medical practice.

Easy medical billing software has now evolved to a place where any staff member of your practice can use it. The simpler programs are usually available in most places where medical billing software is sold. When your office works efficiently, it always translates into better care for your patients. So get on board with the right easy medical billing program and see how simple that paperwork can be.

Medical Billing Software Info provides comprehensive information about medical insurance billing software, HIPAA compliant medical billing software, easy and free medical billing software, and medical billing software prices and reviews. Medical Billing Software Info is the sister site of Medical Billing Web.