In hospice, serving patients and their loved ones by providing compassionate and professional end-of-life care must always be a top priority. But a strong revenue stream is what makes it possible to fulfill this mission. Unfortunately, the tedious and complex process of hospice billing means many organizations struggle to remain profitable.
Workflow that is not fully optimized to protect reimbursement can have a number of negative results:
- Frustrated and overburdened administrative staff
- A backlog of un-filed claims
- Missed deadlines for NOEs
- A high percentage of claims rejected for errors
- A rise in the cost of billing
- A decline in the rate of collections
Any of these factors can cause your revenue cycle to suffer. Understanding where bottlenecks, errors, and breakdowns occur in your hospice billing process is the first step in resolving these issues. Here are three areas where updating your workflow can lead to significant improvement in getting claims paid on time and in full.
Since hospice billing is sequential, any missed steps can throw a wrench into the process. The first hospice claim cannot be filed until after the Notice of Election (NOE) is processed (and any error on the NOE can cause it to be returned or rejected). Mistakes can happen during intake or during the completion and submission of the NOE.
Take time to review the most common reasons for rejected NOEs at your facility to see where the problem is occurring. For example, the correct identification of the provider, the beneficiary’s signature (or the signature of their representative), and the effective date of election are all areas where a mistake can cause problems.
Front office staff may need a refresher on how to complete all required fields correctly, and back office staff should double-check for missing information prior to submitting NOEs.
Everyone knows electronic claims submission is much faster than manual claims processing—and submitting billing in batches is a convenient way to increase productivity. For example, if you are handling this in-house, back-end staff can have a dedicated time set aside to handle this important process without distractions or “context switching” which can lead to errors and omissions.
Bear in mind that once-a-month batch processing is only suitable for submitting claims for billing. NOEs can be submitted electronically in batches, but this should be done daily or as NOEs are created to avoid missing the critical 5-day deadline. Also, Medicare instructs us to file NOEs separately from claims rather than in the same batch to avoid confusion
#3: Make Verification Part Of The Workflow For Hospice Billing
Chasing down unpaid balances is a hassle. It can become a real cash-flow problem when you suddenly find that a whole batch of claims did not make it through the submissions process. But even a delay on a claim here or there adds up over time. If there is a problem with any part of the submission process, it is better to find out sooner rather than later.
Do not assume that either paper forms or electronic submissions will always make it through. Verifying receipt of claims should be a separate step built into your billing process.
Advanced Hospice Management can help you implement best practices across your organization and reduce the burden on your staff. Our team has the tools and experience to handle everything from claims submission and verification to payment processing and billing compliance. Contact us to learn more.