Payers Getting the Best of Your Bottom Line?

October 12, 2008 · Posted in Reimbursement · Comment 

The threat of a 10.6 percent Medicare payment reduction captured the attention of many therapy practices this past summer. Ultimately, the payment reduction was voted down, but the bill had an unanticipated impact on the industry. It prompted many practices to evaluate how they could maximize existing revenue streams and better prepare for future financial challenges.

One innovative approach that has been implemented at therapy practices focuses on analyzing electronic remittance advice (ERA) to reduce denials and underpayments. Using ERA data as opposed to data posted in the billing system or culled from the clearinghouse gives therapists greater insight into denial rates, by payer, as a means of recouping reimbursement.

ERA data analysis allows practices to gain an understanding of why a payer denied a claim so they can prevent future denials. The resulting analysis gives power back to therapists for dealing with payers, and allows them to develop the best possible processes to ensure the full reimbursement they are allowed with the lowest cost of collections.