What is Practice Management?
Practice Management includes the following services:
Verifying patient eligibility and benefits.
Gathering and entering of patient demographics into your practice management
software.
Making sure the appropriate CPT and ICD-9 diagnosis codes correspond.
Being certain that the procedure codes that are supplied by your client are not
part of a CCI edit.
Making sure applicable managed care authorizations and/or referrals are on file for the services performed.
Batching and transmitting your claims to a clearinghouse is the more efficient means of transmission.
Providing follow-up on unpaid claims and outstanding patient balances.
Filing claim appeals when necessary.
Providing Secondary and Tertiary claim submission when applicable.
Posting patient and insurance payments to claims/accounts.
Sending patient statements and, when necessary, letters for soft collections.
Providing your client(s) with accurate monthly reporting on all of the above.
Staying educated and on top of Industry Standards with HIPAA and OIG compliance, as well as Medicare, and State/Local regulations
Thanks so much for the post. I have a buddy who's in medical practice management and I had no idea that they are supposed to provide clients with everything of that they can file claim appeals. I'm gonna have to get after him a little.