hxtr Posted December 22, 2016 Member ID: 220 Group: **- Inactive Registered Users Followers: 147 Topic Count: 595 Topics Per Day: 0.11 Content Count: 16950 Content Per Day: 3.17 Reputation: 13538 Achievement Points: 129713 Solved Content: 0 Days Won: 120 Joined: 09/04/09 Status: Offline Last Seen: October 26, 2023 Birthday: 04/05/1970 Device: Windows Share Posted December 22, 2016 Julie calls me like a month ago and is stressed at her job she took on about 2 months prior. She was hired to look over kicked back billing for whatever reasons and she has a mound of experience in doing so. The company has two biller's and their job is to match insurance with medical codes of service. The Affordable Care Act has made this process even harder as you have to follow so many rules to get paid for services and it is a constant battle under a time line... that is being missed.So mistakes are happening and it is costing the Doctors $20,000 a month or more. Julie job is to take the kicked back from Medicaid, Medicare and all other insurance and fix the coding mistakes and resubmit the claims for payment. It can be a daunting task having to read all the doctors notes and other trying to rebuild a better case so the insurance will pay it. It is a fucking mess and the stress is high.So Julie calls me 30 minutes ago and needing to talk. She is about to quite her job over this now as her job has been kind of threatened. She called a meeting on Friday and that in part is stressing her out. She has been talking to certain bosses trying to explain that the billers need to call and verify the insurance before submitting a claim but the time it takes to do that takes a lot of time and is the problem. With only two billers doing the work as the mistakes come back Julie does not have time in many instances to resubmit the claim in time to make the deadline and they lose that money.... $20,000 lost just last month.So here is what I told her. You are working yourself out of a job. Instead of trying to get the billing and coders to taking on more responsibility how about you have them ask you for help verifying the insurance before they submit them. This way you have plenty of time and they can learn from you in asking for the verification. This way as you get new billing and coders (billers and coders dont last long from the stress) you will be their focal point in training them as you have the knowledge.. they don't.Don't go to your meeting Friday without a solution to the problem. If that means you taking on more responsibility to fix the problem do it. From what I see you will be saving yourself time not having to resubmit a claim plus you will be the focal point in billing and you will become more valuable as an employee.. Julie said a light went on and she has a plan now for her meeting. Wish her luck.. any advice I will send her a link to read it. Her job is not easy and the Affordable Care Act has made it harder and harder for all of them. What to know why.. I will ask her to explain. I only hear about the problems as they happen. Cant wait to hear how the meeting goes on Friday. deerejon, Blackbart, YACCster and 1 other 4 Link to comment Share on other sites More sharing options...
deerejon Posted December 22, 2016 Member ID: 842 Group: *** Clan Members Followers: 62 Topic Count: 278 Topics Per Day: 0.05 Content Count: 3712 Content Per Day: 0.71 Reputation: 3150 Achievement Points: 28451 Solved Content: 0 Days Won: 4 Joined: 12/06/09 Status: Offline Last Seen: 8 hours ago Birthday: 05/04/1965 Device: Windows Share Posted December 22, 2016 That was good advice hxtr....misspellings and all!! Always make yourself indispensable to your employer....just ask the guy I canned on Monday..!!! hxtr and YACCster 2 Link to comment Share on other sites More sharing options... Awards
deerejon Posted December 22, 2016 Member ID: 842 Group: *** Clan Members Followers: 62 Topic Count: 278 Topics Per Day: 0.05 Content Count: 3712 Content Per Day: 0.71 Reputation: 3150 Achievement Points: 28451 Solved Content: 0 Days Won: 4 Joined: 12/06/09 Status: Offline Last Seen: 8 hours ago Birthday: 05/04/1965 Device: Windows Share Posted December 22, 2016 I only saw one.... hxtr 1 Link to comment Share on other sites More sharing options... Awards
JohnnyNashville Posted December 22, 2016 Member ID: 25938 Group: ***- Inactive Clan Members Followers: 21 Topic Count: 343 Topics Per Day: 0.14 Content Count: 1493 Content Per Day: 0.59 Reputation: 284 Achievement Points: 13299 Solved Content: 0 Days Won: 0 Joined: 05/17/17 Status: Offline Last Seen: December 25, 2022 Birthday: 08/08/1961 Share Posted December 22, 2016 When I make a appointment my insurance is verified, my co-pay is verified and my deductible is verified.... example... Me: Hi I would like to schedule a appointment with Dr. Smith to have my penis reduced by 6" Them: Okay I need your insurance Me: Obamacare, Group Number 6969696969 Them: Sorry Obamacare doesn't cover penis reductions...we can do a sex change, then another sex change with a smaller penis... Me: Sounds like government at it's finest!! Them: your co-pay will be 100 dollars and you have not yet your deductible (15,000 dollars) so you will have to pay for the procedure out of your own pocket. johnny hxtr, tsw 8.5 and deerejon 3 Link to comment Share on other sites More sharing options...
hxtr Posted December 23, 2016 Member ID: 220 Group: **- Inactive Registered Users Followers: 147 Topic Count: 595 Topics Per Day: 0.11 Content Count: 16950 Content Per Day: 3.17 Reputation: 13538 Achievement Points: 129713 Solved Content: 0 Days Won: 120 Joined: 09/04/09 Status: Offline Last Seen: October 26, 2023 Birthday: 04/05/1970 Device: Windows Author Share Posted December 23, 2016 When I make a appointment my insurance is verified, my co-pay is verified and my deductible is verified.... example... Me: Hi I would like to schedule a appointment with Dr. Smith to have my penis reduced by 6" Them: Okay I need your insurance Me: Obamacare, Group Number 6969696969 Them: Sorry Obamacare doesn't cover penis reductions...we can do a sex change, then another sex change with a smaller penis... Me: Sounds like government at it's finest!! Them: your co-pay will be 100 dollars and you have not yet your deductible (15,000 dollars) so you will have to pay for the procedure out of your own pocket. johnny Now if you want to cut it off and make a vagina... just join the military. L!ckALotAPus 1 Link to comment Share on other sites More sharing options...
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