Haisten Merchant Services

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The Appeal Analysis Report helps you compare the contract amount of a procedure and the carrier allowed amount to the actual insurance payment. The last column indicates whether a transaction should be appealed or not based on underpayment by the insurance company.

If contractual obligations are not being met by insurance carriers with regard to a particular procedure code or filed claim, you should formally appeal their actions. If a formal appeal is chosen to be the course of action, this sample letter can be used to appeal a claim.

This report deals with the timing of appeals. The report assist in tracking and monitoring each pending appeal.

The Appeals Trend Analysis report groups the pending appeals entries by carrier for easy trend identification. It is easy spot trends and take action using this report.

This patient aging worksheet shows amounts for transactions that are overdue. The patient’s information is displayed allowing the staff to contact these people and pursue the outstanding balances.

The goal of each letter is to move the recipient to action in a straight-forward manner. The simpler and clearer the letter, the better chance of success. These letters use data from MediSoft/NDCMedisoft to fill in the pertinent information.

MediSoft/NDCMedisoft keeps track of the dates transactions are billed. Rebilling is often necessary for lost or ignored claims. If transactions are rebilled, it is sometimes difficult to keep track of when they were rebilled or  for what purpose they were resubmitted.

Use this report to show payment activity. Specify the range of dates for the Next Payment Amount as the current period i.e., Month, Week, etc. This will help identify delinquent payments and more accurately track payment activity.

The Insurance Comparison report compares any carrier’s allowed amount with Medicare’s allowed amounts. If the carrier’s reimbursement schedule should be a true percentage of Medicare, all fees should be the same percentage.

A copy of this face sheet should be placed in each patient’s chart. It contains vital information that may change from time to time. The purpose of the face sheet is to provide information needed to care for the patient without having to dig through their chart.

This report chooses twenty five random charts from the patient list to assist in selecting random charts to be audited. The purpose of an audit is to identify any inconsistencies or missing information between charts.

Audits should be performed regularly on patient files. This reports helps track patient audits to show timing intervals.

This is a summary of all payments entered into the computer and is sorted by payment type. This helps you balance and identify payments that may have been received but have not yet been entered.

This report is a secondary balancing tool. It lists every procedure that was billed during a period and the associated charges. Compare the total on this report with the total added up from each superbill for another way to check balancing.

This report shows any trends which can be addressed by management. Rebilling is pure expense -- especially when the bill could have been submitted correctly the first time. Use this report to help control constant rebilling or fixable errors so rebilling becomes less common.

This reports helps compare carriers using the amount received from that carrier as the main criteria. This report can also be compared with the other Top 40 Insurance Carriers reports to see if the ratio of patients to money received is in line.

This reports helps compare carriers using the number of patient visits attributed to that carrier as the main criteria. This report can also be compared with the other Top 40 Insurance Carriers reports to see if the ratio of patients to money received is in line.

This report will list the top 40 codes that are used most often in the practice. Using the method discussed in the book, add additional procedure codes that may be performed less often but that are reimbursed well. This report becomes a management tool to help decide which services to offer and promote through marketing efforts.

This sheet helps you balance cash. This goes beyond patient accounting because there may be expenses that take cash which are unrelated to cash received from patients. This helps you track ALL of your cash.