Standard Operating Procedures and Best Practices
Registration / Front Desk
Scheduling, Registration, and Front Desk are financial functions. Make sure you and all users are trained on these Best Practices.
Focusing on the front end of the Revenue Cycle makes a big impact on end results and your practice’s ability to get paid for all services.
- The Job Scheduler can be used to automate many of these tasks.
Daily Reports and Actions
Daily Reports
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Reconcile Receipts per cash drawer.
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Reconcile Charges.
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Some clients prefer to have separate Reference Batches for:
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Each User
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- Review and work (correct and resubmit) Clearinghouse Rejected, Payer Rejected, and Local Edit Errors.
- Use as a bank deposit reconciliation.
- Use to check all financial activity for the day (such as charges and receipts).
Daily Actions
- Open Reference Batches to manage financial transactions. Review and Close at the end of the day.
- Manually Batch and Upload Statements (use the job scheduler to electronically auto-upload). Manage Clearinghouse and Payer Rejections.
- Post Manual Insurance and Patient Payment upon receiving.
- Post ERA on the Received Date. Post Medicare payments first.
- Review Custom Worklists if you are using them and Denial Worklist for action items.
- If Charges are automatically created from your clinical documentation, make sure there are no mappings to resolve.
Weekly Reports and Actions
Weekly Reports
- Work this list for current Outstanding Insurance Balances (A/R). Outstanding Patient Balances are also shown on this report.
- The Interactive Aging button is located on the Home Dashboard.
- For balances to Insurance, use this report as a call list.
- Filters are available to search specific Insurance, Balance, Aging, Percentage, etc.
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For Outstanding Patient or Insurance balances and Credit balances.
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Responsibility Date: The date that the party became responsible for the balance. For non Self-pay patients, it is the date the balance was transferred to the patient. If Self-Pay, it is when the charge was posted.
- If you are using the Calendar, use this as a check and balance. If the patient kept an appointment, do we have an encounter (charge) in our system?
Weekly Actions
- Upload files before 1:00 PM EST. Best days to upload are Monday-Thursday, to avoid delays over the weekend. Review the Statement errors in the Address Corrections - Needs Changed / Do Not Mail panel.
- Review RCM reports such as Interactive aging, Unresolved claims, and Aging by Patient.
Some smaller practice's may prefer to send statements on a monthly schedule.
Monthly Reports and Actions
Monthly Reports
- Use as an audit for receipts received, payments posted, and any money in escrow.
- Make sure all Insurance escrow is posted before you run end-of-period reports.
- Reconcile credit card statements.
- Review patient credit - Patient Credit Management.
- Review high, unpaid balances.
- Days in A/R: Total A/R divided by the average billed amount per day over a time period.
- Net: (Charges - Payments - Adjustments - Transfers + Refunds)
- Compare month to month and see the beginning and ending A/R.
- The number of Patients seen and the number of Encounters.
- All Charges, Payments, Adjustments, Write-offs, Refunds, and RVUs.
- Transfers: The money moved (transferred) from/to the next responsible party.
Monthly Actions
- Review Incomplete Charges to see if it is possible to complete them.
- Review Patient Refunds and Insurance Credits for Refunds that need to be made or to Re-apply a Patient Credit.
- The Aging by Patient or Interactive Aging Reports can be used for this purpose.
- Close the financial period.
Collections Reports
- The User can System generate or create your own.
- Use as a call list for Pre-Collection efforts.
- Use to send accounts to a Collection agency.
Yearly Reports
- Year End is assumed to be a calendar year (Dec 31). If you close at a different month check end of year.
- Taxes Collected, if used.
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