Academy of Chiropractic’s Lawyers PI Program

Office Systems #21

From the Desk of :

“Get Paid & Prevent Retrospective Audits”

The Billing Self-Audit

Years ago, I will getting audited much too frequently and not happy with my percentage of collections. I was very busy and we were collecting in the low 60th percentile for all financial categories yet I was extremely happy with my billing and collection staff during this process. The staff got the bills out every week and was on top of the collection process based on the regular feedback they gave me. The biggest problem was I believe them through the process of abdication and did not request verification through what should have been a process of delegation.

The reality is I was no different than many of you, young and stupid. The only difference is as I got older I stayed stupid and did not even consider or know how to add verification systems into my practice. Here are the changes that I made:

1. I switch my billing to every two weeks
2. I had my insurance staff print on a spreadsheet the following information
     a. Patients name
     b. Dates of services
     c. ICD numbers linked with CPT numbers
     d. Fees for service
3. I then had my staff pull every chart and I cross-referenced my chart notes with what was billed.

Basically I was getting a complete listing of every patient treated within a two-week period of time along with every service enter into our billing system.  

The results were confronting and revealing as to why we were being audited so frequently and why our collections were not close to where they should have been.

This process held true for every financial class and as a result our audits reduced tremendously (we also instituted sending chart notes with every claim) and our collections increased greater than 20%. This process also showed me where my notes were deficient and put my staff on alert to be much more efficient and careful when entering codes. It also told me with staff need to be terminated and who needed to be retrained.

One of the biggest lessons I learned was that I needed to understand my billing system so that I wasn’t stuck working for my staff. Therefore I hired an independent person to train me through the software company. I was never going to work for my staff. 

This process continued until I retired from active practice and made me a lot of money along with giving me “peace of mind.”