The process of reviewing and scrubbing patient accounts refers to ensuring that all of the details of a patient account are as up to date as possible, and are accurate according to all of the information we have. Accounts should be “statement ready” to the greatest extent possible, allowing clinicians to be confident that the patient balance is up to date and accurate to the best of our knowledge.
Account reviews occur by billing technicians as part of several regular processes. If a technician has reason to go into an account to adjust a session or review a particular claim, they should perform a cursory review of the account to look for any needed adjustments. Similarly, before any patient bill goes out, a review of the account for any needed adjustments should be performed. Usually this is brief with little work needed.
**This step should be triggered by any 90791 Superbill***
New patient accounts should always undergo an initial review by the billing department to ensure that the billing settings have been properly applied, and that the account defaults reflect the insurance benefit information we have. The receptionists should request such a review when they first enter patient information into an account at the time of the intake appointment. The billing technicians should make sure that has been done prior to submitting any 90791.
It is the responsibility of the billing manager to refine, wherever possible, the process of keeping accounts “statement ready”, and to avoid any inaccurate patient bills as much as possible.
Opportunities to ensure accurate account information are during EDI submission, processing ERA\EOB returns, when posting patient payments, when updating any account insurance information.