Resource:Figure 10-3 of Essentials of Health Information Management: Principles and Practices (2nd ed.)
This week, you learn about the claims management process. While most billers understand how sending claims and receiving payments affect finances, few understand the steps an individual can take to increase timely reimbursement.
The Aging Report is arguably the best defense in keeping the practice financially secure. With this report, all balances (insurance and patient) can be reviewed each month to ensure payments are being made and problems are handled in a timely manner. In a well-run office, the billers will be required to “work their aging” every month. This means they will be given a report of all their accounts over a certain age (usually 45 to 60 days) and will be expected to follow up on each account that has not yet paid.
Write a 700- to 1,050-word essay based on this described model that explains claims processing and the efficiency of using reports. Address the following in your essay:
- Describe the purpose of the encounter form (also known as the superbill).
- What impact does managing claims according to this model have on the financial health of the practice?
- Do you believe “working your aging” is a task worth the time it takes? Why or why not?
- What are some reasons an office may decide not to make this a routine part of their process? Are there ramifications to this? Explain.
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