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Home infusion cash posting 

Webinar

The vital role of the home infusion cash poster

By: Mary Marzec, Sr. Reimbursement Coordinator, WellSky Revenue Cycle Services 


Home infusion billing is extremely complex and with dwindling margins, it is so important to make every dollar count. When analyzing the role of the home infusion cash poster, many organizations consider this a clerical role, but at WellSky Revenue Cycle Services, we view this very differently. WellSky Revenue Cycle Services only employees experienced billing and collections staff to fill one of the positions on the cash posting team as this job is vital in ensuring that payments are applied as soon as possible, with a high-level of accuracy; and with all of the ancillary steps completed at the time the cash is posted so your business can run smoothly.

Completing all of the steps up front eliminates a great deal of duplication and time spent researching an EOB to make small adjustments, to transfer a copay, etc. By hiring experienced staff in this role, it may cost a little more in terms of salary, but it will not only save you money in the long run, it will also ensure you are on top of any unexpected payer trends. See below for a few tips on how you can improve your cash posting process.

Time management is key: The cash poster must process payments received in a timely manner so that the collection team is not following up on claims that have payments just waiting to be posted. If this occurs, the collection team will push back their follow up schedule as they don’t want to have to track down checks that have been paid to the provider if they are sitting in a file waiting to be posted. A best practice is to process (auto or manually post) incoming payments within two days or less. For large payments that come into the organization, these could take many hours to process. Therefore, it is important to manage each day with the most urgent payments that need to be applied.

Accuracy is vital: With the urgency of cash posting tasks, and the volume to get through, an employee can easily become overwhelmed. Typically, a cash poster is working at a fast pace to get all payments posted on the same day they are received. However, working too fast can cause further complications down the line if payments are entered wrong into your software system. Using your billing software tools is a great quality check to make sure your cash posting total in the system balances to what was actual deposited. If there is not a zero-balance on a claim, but the claim was paid in full, this typically indicates an error has occurred. The error could be that the revenue was booked too high or too low; or it could mean there was a posting error. Most software systems will not let you post a batch until the balance discrepancy is resolved, which is a great tool to allow you to take a step back and revise the entry to correct any errors. To find these errors, the cash poster will need to look back at the remit, and review invoice by invoice or check by check. Additionally, with auto-posting (and manually posting) you may find that the payer has additional transactions (such as a recoupment for an incorrectly paid claim) at the end of the EOMB that was initially overlooked. Lastly, it is very easy to mistake a recoup as a payment which could cause the balances to be off. Thus, tying to the total check or deposit is key.

Understand payer terms: Many insurance carriers have unique nuances in terms of how claims should be billed, and also how they are paid. Thus, it is in the best interest of the cash poster to understand all insurance carriers’ EOMBs. It is recommended that the cash posters keep detailed notes on each major payer to refer to in the event a unique scenario occurs. They should also have notes/instructions (often by payer, drug, or therapy) when to adjust or transfer a balance; limitations on amounts that can be adjusted or transferred; and which codes to use to identify each transaction. In some instances, although HIPAA has brought a great deal of standardization, you will still find the need to set up specific adjustment codes for payments, denials, or even adjustments that are unique to a payer.

The puzzle piece connecting everything: Cash posters can do much more than just posting payments. They are often the first to identify when errors from the payer occur or when new trends seem to happen. If there is a payment from a payer that is less than was expected or even more than expected, it is important to call the payer to ascertain the reasons why the over or under payment occurred. If you assign your cash poster to simply post the payment and nothing more, it only will require your collector to spend time researching a scenario that could have easily been solved by the cash poster. We encourage the cash poster to report anything out of the ordinary to the reimbursement manager and/or the billing team so everyone is aware of a potential issue and can work together to solve. Empower your cash staff! Let them solve the puzzle! If you permit, even encourage, them to be involved and participate in the success of the reimbursement team, you will be amazed at home productive and efficient you can become.

Home infusion billing can be challenging, especially managing high volumes of payments to a variety of insurance providers. WellSky Revenue Cycle Services billing and collections team is a great source of help to manage your pharmacy billing and collections. For more information on our services, please click here.

Revenue Cycle Management

Recorded Oct 23, 2018

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Presenter: Jill Dyer, BSN, RN, HCS-D, HCS-O

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly.


Presenter

Presenter: Jill Dyer, BSN, RN, HCS-D, HCS-O

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly.

Presenter

Presenter: Jill Dyer, BSN, RN, HCS-D, HCS-O

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly.

Presenter

Presenter: Jill Dyer, BSN, RN, HCS-D, HCS-O

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly.

About WellSky

WellSky is a technology company that delivers software and services to transform an ever-growing range of care services worldwide. We anticipate the needs of care providers and communities, empowering them with insights and solutions that support high quality, scalable, and personalized care. With our platforms and partnership, care providers can deliver their best while managing costs and resources, so both businesses and communities flourish.

Building on a history of excellence and a reputation for quality, WellSky empowers providers to provide exceptional care, improve operational efficiency, reduce cost, and meet the challenges of their rapidly changing industries. Learn more at WellSky.com.

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About WellSky

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly. So they're able to anticipate — and exponentially increase — the impact of care.

About WellSky

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly. So they're able to anticipate — and exponentially increase — the impact of care.

People who choose a life of caring — and the organizations and communities they serve — deserve a special kind of support. So we help them to care smarter. Liberating them to focus on the people they serve. Providing solutions that make work flow, integrate insights, and update effortlessly. So they're able to anticipate — and exponentially increase — the impact of care.