Research by the CMA indicates that physicians don’t bill for at least 5% of the insured services they provide. This chapter will help you avoid some of the common challenges that lead to underbilling for your work.
Here is a brief synopsis of the tips we’ll cover in Chapter 4:
4.1 Track Your Income
Staying connected to your income is an important part of ensuring you are being paid accurately for the services you perform.
Check out the full version of our AHCIP Billing Guide for the pitfalls you should watch out for when outsourcing billing to a third party.
4.2 Use Applicable Modifiers
Adding applicable AHCIP modifiers to your billing codes is important to ensuring you are paid accurately for your work.
Modifiers can increase the value of a service provided based on service/patient complexity, physician role, time of day and length of time spent with a patient.
In the full Ultimate AHCIP Billing Guide, we outline some of the most common modifier types:
- Complexity Modifiers
- AGE
- BMI
- CARE
- After Hours Time Premiums
- CMGP Time Modifier
Helpful Resource:
See our quick-reference Modifier Guide for a simplified alphabetical list of modifier definitions.
4.3 Bill For Telephone Consults
Many doctors engage in telephone and e-consultations, yet neglect to bill for them, which adds up to a lot of unpaid time.
Both the referring physician (the doctor who initiates a call) and the consultant physician (the doctor who receives the call) can bill for qualifying telephone consults. Note that consulting physicians may bill applicable codes when providing qualifying advice to another physician as well as to a nurse practitioner or midwife.
Find descriptions, codes and values for these consults in our Ultimate AHCIP Billing Guide.
The Medical Billing Solution for Doctors.
4.4 Collect Applicable Rural Incentives
The Rural, Remote, Northern Program (RRNP) helps compensate physicians who practice in under-serviced areas throughout Alberta.
Learn more about qualifying for Variable Fee Premiums, Flat Fee Payments and the RESIDE program in the full version of our Guide.
Did You Know?
If you are using Dr. Bill, we can add your rural location to your account settings in order to ensure that rural incentives will automatically apply to your claims.
4.5 Avoid Rejected Claims With These Tips
Claims can be rejected, refused or reduced for a variety of reasons—from a simple patient information error to incorrect use of a code. The good news is that many of these claims can be remedied and resubmitted for payment.
The process of investigating, correcting and resubmitting claims can become arduous for physicians doing their own billing. As a result, some physicians simply end up letting some or all rejections go, which can add up to a lot of lost revenue over time.
In the Ultimate AHCIP Billing Guide, we’ll review the five most common reasons for rejected claims. When you keep these in mind, you’re likely to experience fewer unpaid claims.
Did You Know?
Dr.Bill users receive proactive alerts before claims are submitted to prevent many common errors.
4.6 Use AHCIP Billing Best Practices
With years of AHCIP billing experience under our belts, we have some no-nonsense tips to share to help you maximize billing and ensure timely payments.
In this section, we’ll cover how frequently physicians should submit claims, tips for avoiding audits and much more.
