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Maximizing Revenue

The-revenue-cycle-process-graphic

Scheduling & Eligibility

  • Collect as much information as possible by phone at the time of scheduling i.e. insurance eligibility, demographics and reason for visit.
  • As soon as the appointment is made, verify clients insurance information.

Client Registration

  • Registration area or check in area should be HIPPA compliant.
  • Verify demographics, and obtain signed paperwork.

Coding & Documentation

  • Encounter forms or Superbill should include CPT codes (new, established and comprehensive visits) and ICD-9 codes.

Fee Collection

  • Ensure client confidentiality when assessing clients ability to pay.
  • Confirm insurance to be billed or implement sliding fee scale.

Claims Submission

  • Educate patients on the financial obligation and cost of services.
  • Ensure all required information is complete and review the superbill or encounter form.
  • If you have a Practice Management System or EMR, claims forms should be pre-populated.

Remittance Processing

  • Payment should be received within 10‐15 days; Address denied claims and outstanding balances.