Collections: Educate staff, patients

Q. Should I review and audit our intake and documentation processes?
Tuesday, September 24, 2013

A. Proper communication and training  between staff and patients is crucial at intake to ensure documentation is completed. 

At times, this is overlooked and not audited to ensure the patient has what is necessary or if the patient has been informed on how to complete the documentation properly to ensure accuracy from the start. Many of the challenges seem to be patient eligibility, delivery ticket signature, intake documents, overutilization errors and clinical documentation necessary at intake and especially the proper usage of the ABN. This falls to the patient’s unfamiliarity with his or her own insurance policy. Lack of knowledge on both sides of the equation can be disastrous. 

To decrease unnecessary denials and loss of revenue, the staff must follow the correct processes set forth by management—and management must ensure the process is being followed by being hands on. 

Inquiring—at intake—directly with the payer, clearinghouse or the software system resources will ensure accuracy. For example, the patient must complete the delivery ticket as instructed and must understand fully what and why the information is necessary for billing. For the patient to be held responsible, the staff must be educated on the importance of each document and the purpose. 

The delivery personnel must also have the ability to review/explain responsibility to the patient or caregiver. 

Without the necessary patient education, loss of revenue will be inevitable for the provider because of the lack of documentation that proves they are owed the money by the patient. The provider must collect what the patient owes; this can be controlled by proper documentation and education of the staff and the patients.

Kit Shellhouse is vice president of operations for ECS Billing & Consulting North. Reach her at kshellhouse@ or 419-448-5332.