Best Practice Strategies to
Optimize Revenue
Maria Mason
Medical Group Business Services
Manager, Client Services and Analysis
MGBS Billing Brown Bag, November 16, 2006
Review of Patient Registration
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Accurate IMF Plan
Process for Obtaining Benefits and
Authorizations
Communications Regarding Arrival Times,
Records, Authorizations, Co-Pay and CoInsurance
Review and Monitor Front Desk
Processes
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Well Defined Patient Flow Process
Check-In and Check-Out
Co-pay, Co-Insurance and Small Balance
Collections
Ways to Secure Payment – Credit Cards, PrePayment, Holding of ID
Patient Histories Completed in the Waiting
Room
Accuracy of Face Sheets, Copies of Insurance
Cards, Updating in IDX of Changes /
Revisions
Review of Encounter Forms
Update Regularly to Allow MDs to
Capture all Charges
 MDs to Complete the Encounter Form
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Review and Monitor Charge
Capture and Batching Processes
Implement goals to minimize charge lag
 Identify Problem Areas
 Reconcile Services to Charges
 Monitor to Ensure Compliance
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Regular Review of Monthly IDX
Reports
AR Analysis
 Rejections
 Periodic Open A/R
 Periodic Reimbursement Analysis on
Top Procedures
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Regular Review and Audits of
Coding and Compliance
Department Compliance Plan
 CPC Trained Staff
 Review of MD Coding – PDS
 Random Review of Charts
 Feedback to MDs, Training
 Development of Templates for Dictations
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Network and Participate in
Meetings w/Other Revenue Staff
Resources That You Might Otherwise
Not Know Were Available
 Pilots and Other Opportunities
 Conferences Related to Your Specialty
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Other Potential Areas to
Optimize Revenue
Coding
 Units
 Prolonged Services and Time Based
Coding Where Appropriate
 New Codes
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