As medical billing system complexity and functionality grow in step with growing number of users, the number of training hours per month grows by two orders of magnitude, as a product of increasing training frequency and increasing number of training hours required for each user. The development or billing managers, who must juggle training and support in addition to their main responsibilities, reach a point of over-extension, where none of the responsibilities are delivered well enough. A new, better scalable training and support approach is needed to meet the additional requirements.

The typical scaling up path for training and support includes a three-pronged approach:

* Introduction of formal training and support tracking systems,
* FAQ analysis, and
* Development of knowledge repositories aimed at reusing training and support expertise according to the results of the analysis stage.

First, a formal tracking mechanism for both training and support provides continuously updated information about frequently asked questions (FAQ), individual training and support workloads, response delays, and customer success in absorbing instruction. Predictably, the analysis of most frequently asked questions and answers often shows that a comprehensive and effective initial training eliminates a significant number of help requests. Moreover, customers can find answers up to eighty percent of FAQs immediately and directly by using some sort of a shared knowledge repository, e.g., wiki. Most billing companies using Vericle billing network, follow a two-step approach: first, they create a shared knowledge repository for instructional and support-related material, and second, they establish a training department, staffed with instructors who are able to develop a minimal set of training classes for various user categories (providers, front office managers, billers). The classes typically address various functional parts of the practice management system, such as Help system, Initial Patient Intake, Workbench, Scheduling, SOAP notes, Reporting, Billing, Personal Injury, Care Plans, etc.

The shared knowledge repository gradually accumulates educational mass, starting with frequently asked questions and answers, and with time adding videos of instructional sessions and various support email threads. The instructors move away from ad-hoc individual classes to a predetermined monthly schedule of live daily classes over the Internet (webinar format). In spite of the concern about diminished personal attention, subsequent surveys confirmed that majority of clients valued their own time more than personal handholding, and preferred the immediate automated response to a delayed personal conversation over the phone.

In summary, the increased scale of medical billing systems generates more sophisticated training and support requirements, which can be characterized as:

1. Training and support proximity: High - The separate training and client support departments converged as billers outside of the training department grew more comfortable with shared knowledge bases and began contributing instructional material and answers to FAQ;
2. Degree of personal accountability and transparency: Significantly improved accountability and transparency generated important requirements and prepared the content for the next step; and
3. Efficiency: High - The Internet infrastructure provides the minimal level of scalability that enables a single training session delivered remotely to handle an unlimited number of users, liberating the development and billing managers to focus on their own tasks.



Article Source: http://EzineArticles.com/?expert=Yuval_Lirov

In today's world technology is always changing. The evolution of technology is making its way into the lives of Chiropractors who now have new software to use in their offices. Billing services have taken the opportunity to use the software that has been born out of new technology.

The biggest rewards that the software used by billing services has given Chiropractors is ensuring the happiness of their patients and giving patients better results . By using new computer software, billing services have allowed Chiropractors to stay on schedule and not loose rack of their patients. The computer software used by billing services has the ability to check if patients are keeping up with their appointments and coming into the office regularly. This helps them maintain a healthy lifestyle and ultimately betters their life.

Because of the computer software used by billing services, patients feel taken care of. Chiropractors are able to stay focused on their patients and never loose track of a patient and their appointments. Patients are not going to get lost within a system because the computer software used by these billing services are keeping track of patients for Chiropractors. Technology is helping Chiropractors to stay focused with computer software.

Patients can be tracked throughout multiple offices with the computer software used by billing services. All of their information from their appointment time to an x-ray they have had taken is in the computer's system thanks to this software. Chiropractors now have an easier time knowing the care plans of patients and when their last care plan took place. A patients history is now easier to access and organized. Now chiropractors can click a few buttons and it is in front of them on their computer screen. It is also easier for Chiropractors to add or subtract information to a patient's care plan and keep up with that information to keep insurance companies satisfied. SOAP notes can be sent to insurance companies right away and Chiropractors will not have to worry themselves about whether or not they are done correctly.

Computer software used by billing services allows Chiropractors to work in real time. They can work on a patient and use the software at the same time to ensure that they are documenting everything at the right time and getting all of the details so they don't have to go back and try to remember them at a later date. Computer software allows a very thorough documentation of each patient visit.

As patients get better and see an improvement in their health, along with the attentiveness shown by their doctor, Chiropractors are seeing them continue to return. Patients want to stay with the practice longer and are bringing in more referrals for the practice. With more patients, revenues rise and practices blossom.

Computer software used by billing services is an easy solution for Chiropractors. This software will keep patients on track and therefore keep Chiropractors more focused. Technology is now helping secure healthy patients for Chiropractors and in turn healthy patients are helping practices to flourish and operate at their best.



Article Source: http://EzineArticles.com/?expert=Gina_Bortolussi

What to Do When Your Chiropractic Exams Are Downcoded

If you are having trouble with exam downcoding in your chiropractic billing - in other words, you bill for a 99204 but the insurance only pays for a 99203 or you bill for a 99213 and the insurance pays for a 99212 - keep reading because this article can potentially put thousands back in your pockets!

Trends in Downcoding
Downcoding is not new, nor is it a passing fad. The practice of an insurance company paying you lower fees and at a lower code that you billed is also not unique to chiropractic.

Basically, from the insurance perspective, here's the inside scoop on how downcoding occurs. (As many of you already know, I fully admit that I used to work as an insurance claims analyst and so I have an intimate knowledge of their methods!)

Everyone is NOT Downcoded
Rest assured, insurance companies do not try to downcode every possible E/M or exam code for every provider every claim. However - certain E/M codes are highly audited in the chiropractic profession and subject to near constant downcoding.

Which ones? For chiropractors, the biggie is 99205. In fact, there are many even within the chiropractic profession who will go on record and state that DC's have no business using that code.

Downcoding 101
While exam codes such as 99205 are pretty much automatically flagged in the chiropractic world, most insurance companies employ sophisticated software tracking systems to determine which codes under which circumstances they will target for downcoding.

How does one get on such a hit list?
Easy. Your coding trends are significantly outside the "normal" values that your peers submit.

Let's look at it this way: if your peers bill 99203 20% of the time and 99202 80% of the time but you bill the reverse - 99203 @ 80%, the software at your friendly insurance carrier is programmed to "kick you out." Once labeled an "outlier" your claims are tracked and either immediately or periodically subject to downcoding.

In other words, the insurance company will try to bring your claims back to the middle - what they consider "normal" patterns.

The Real Issue With Downcoding
No one likes to be an outside, but the real meat behind the issue of downcoding is dollars lost! Every time your claims are downcoded, you are forced to fight to defend your care. Every time you fight, you lose some $$$ just because of staff time spent fighting.

Now, one solution is to not fight back. Bad idea. Call me crazy but I believe that if you truly perform a 99203 then you should be paid for a 99203!

The other solution is to "play it safe" or stay under the radar and downcode yourself. I know many DC's who use this strategy and while it is true that they aren't audited as much, they are also losing thousands of dollars each year by not asking the insurance companies to pay them for what they do.

My Solution
My solution is rather simple: know your stuff and be paid for everything you do.

Knowing your stuff is a problem for some DC's not because they are bad chiropractors, but because they know virtually nothing about billing and coding!

The Most Common Error in E/M Coding
When I audit one of my client's claims or exam notes to determine if they are compliant and correct, here is one near universal mistake that I repeatedly see DC's making.

Neglecting the Review of Systems is by far the easiest way to perform a sub-par exam that will get downcoded!

ROS, the Key to Highly Paid Exams
As you know, each E/M code has criteria - history, exam medical decision making - that you have to meet in order to merit a particular level of exam code.

In other words, you can't bill out a 99205 (the highest level E/M code) while performing a brief exam worthy of a 99202 and expect to be paid fully!

For many DC's the stumbling block that virtually causes their claims to be downcoded is the ROS.

A Complete ROS
For a complete Review of Systems, it is necessary that you cover and document ten (10) individual bodily systems in your examination.

Cover less than this and you will not be eligible to report a complete examination and thus, you automatically pull yourself out of certain billing levels.

Nearly all coding books (if you don't yet have one, get one) have a section detailing which E/M codes require complete exams or more detailed documentation to merit the code.

Frequent Downcoding or Audits
If you are getting dowcoded or audited frequently, chances are your Review of Systems is lacking.

If you are performing a complete exam but not getting paid for it, thereis a high degree of likelihood that your documentation is the problem.

Either way - you are losing out on money for things you are doing - not good in my book!

The Good News
Here's the good news, doc.

Fix your Review of Systems and you are on your way to "earning" the right to code for higher level examinations and also on the right track for reducing your exposure to audits by billing incorrectly!

It's easier than you think and does not require you to spend loads of time in your exam performing every test known to man. You just need to be able to know what the requirements are - and satisfy them.

Now, go back to the office - review your ROS and get paid for EVERYTHING you do!



Article Source: http://EzineArticles.com/?expert=Tom_Necela