It would be a privileged for CBS to have the opportunity in assisting your facility in developing Training, Education, Policy, Procedures, and possible Re-Billing of LMRP (LCD’s) and ABN’s procedures. CBS has a great understanding of the importance in developing this particular portion of Medical Billing, Admission, and Registration.
Having worked with other facilities on this same subject matter, CBS has developed key training and education techniques that will develop and improve the “front end” of the admission and registration department which deals with the day-to-day issues involving LMRP (LCD’s) and ABN’s procedures. CBS encourages those employees, directly involved with this area of concern, to relay their dilemmas to CBS; and we will work together as a team to create policy and procedures that will work universally within all outpatient departments and their admission and registration areas.
In regards to the “back end” process or the billing office, CBS has, again, developed ideal ways to identify procedures that are possible LMRP (LCD’s) and/or ABN’s issues. By working alongside your facilities employees within said department, CBS will analyze and identify their concerns. With constant communication and team effort, we will develop policies and procedures that will work with any “back end” software your facility chooses to implement.
CBS has been able to recapture revenue previously thought as either “Non-Covered” or “Contractual Adjustments” going back as far as 18 months from the DOS on Medicare claims. The success rates have been overwhelming with our clients regarding this project, and they have been surprised in the amount CBS has been able to recover in lost revenue.
As CBS focuses on the facility with LMRP (LCD’s) and ABN’s issues, this project will not be successful without the proper training and education of the physicians. CBS has developed a specific training program by our compliance attorneys for all physicians, regardless of their specialty. The CBS legal department lays out in specific detail the rules and regulations required by CMS and the OIG regarding the physician’s involvement with LMRP (LCD’s) and ABN’s.
The results are outstanding and usually physicians are willing to inquire on additional software that will assist them in identifying LMRP (LCD’s) and ABN’s procedures to alleviate the stress of upset patients when billed for services they requested, and not initially informed of non-coverage issues.
The following is detailed description of its services regarding LMRP (LCD’s) and ABN’s procedures:
Assessment of Current Procedures:
CBS will require meeting with the following crucial employees to assess the current procedures involving LMRP (LCD’s) and ABN’s for each facility:
* Admission Director * Registration Manager or Director
* IS for LMRP (LCD’s)/ABN’s Software * All Registration/Admission Employees
* Lab Director or Manager * Radiology Director or Manager
* All other Directors or Managers of any other Out Patient Service the facility provides.
CBS can meet with these key department directors/managers and their employees by department, allowing CBS to verify how each department’s procedures function with one another and most importantly, what each department assumes the other department has in process. CBS has found from past analysis that one department generally believes another department is fulfilling certain processes, when in fact…they’re not.
The following will be assessed within each department and with each employee:
- Knowledge of Software
- Knowledge of what LMRP (LCD’s) and ABN’s and what they mean to the facility, physician and patient
- Knowledge of their own department’s policies and procedures
- Function of each department’s processes
- Knowledge of other key departments’ processes
- Knowledge of how to handle patient questions and complaints