SEOTEMBER 10, 2024
How to Achieve a Clean Bill
in Long-Term Care
…and how PointClickCare’s Integrated Solution Can Solve Billing Discrepancies
A clean bill in long-term care (LTC) means that month-end invoices are free from erroneous charges. This not only improves financial accuracy but also reduces administrative burdens and ensures timely payments. This article details how LTC facilities and pharmacies can achieve a clean bill.
A clean bill in long-term care (LTC) means that month-end invoices are free from erroneous charges. This not only improves financial accuracy but also reduces administrative burdens and ensures timely payments. This article details how LTC facilities and pharmacies can achieve a clean bill.
1. Maintain Accurate Census Data:
Real-time updates: Ensure that census data at both facilities and contracted pharmacies is regularly updated throughout a resident’s stay. This includes changes in room assignments, service levels, and discharge dates.
Regular audits: Conduct periodic reviews to ensure census data is correct and identify any discrepancies before they can become problems later.
Automated systems: Consider using automated systems that can streamline census data management and reduce the risk of errors that could become irreconcilable for LTC facilities.
Real-time updates: Ensure that census data at both facilities and contracted pharmacies is regularly updated throughout a resident’s stay. This includes changes in room assignments, service levels, and discharge dates.
Regular audits: Conduct periodic reviews to ensure census data is correct and identify any discrepancies before they can become problems later.
Automated systems: Consider using automated systems that can streamline census data management and reduce the risk of errors that could become irreconcilable for LTC facilities.
A Purpose-Built Solution: Clean Bill
Clean Bill integrates with PointClickCare to deliver a purpose-built solution that ensures facilities and pharmacies know exactly when resident coverage changes and EHRs are up to date.
With Clean Bill, you can:
Eliminate the need for costly, third-party invoice audits
Block Medicare Part A fills as soon as coverage changes
Stop incorrect billing that cost LTC facilities
Ensure pharmacies and facilities have up to date census data at the time of dispensing
Clean Bill integrates with PointClickCare to deliver a purpose-built solution that ensures facilities and pharmacies know exactly when resident coverage changes and EHRs are up to date.
With Clean Bill, you can:
Eliminate the need for costly, third-party invoice audits
Block Medicare Part A fills as soon as coverage changes
Stop incorrect billing that cost LTC facilities
Ensure pharmacies and facilities have up to date census data at the time of dispensing
2. Verify Pharmacy Coverage Information:
Accurate coverage data: Before submitting claims or filling medications, verify that the coverage information for residents is correct in LTC pharmacy systems. This includes Medicare Part A eligibility, co-pay amounts, and any applicable deductibles.
Pharmacy coordination: Maintain open lines of communication between facility and pharmacy to address any questions or concerns regarding coverage information.
Accurate coverage data: Before submitting claims or filling medications, verify that the coverage information for residents is correct in LTC pharmacy systems. This includes Medicare Part A eligibility, co-pay amounts, and any applicable deductibles.
Pharmacy coordination: Maintain open lines of communication between facility and pharmacy to address any questions or concerns regarding coverage information.
3. Minimize Retrospective Adjustments:
Support correct billing: By ensuring accurate census data and coverage information, you can ensure correct payers are being billed during a resident’s stay, minimizing the need for retrospective adjustments to month-end invoices.
Clean claim submissions: Ensure that all claims are complete and accurate before submission to avoid delays or denials.
Follow-up on claims: Monitor the status of claims and follow up on any denials or delays. Claims tracking systems are the most cost- and time-efficient way of tracking claims statuses.
Support correct billing: By ensuring accurate census data and coverage information, you can ensure correct payers are being billed during a resident’s stay, minimizing the need for retrospective adjustments to month-end invoices.
Clean claim submissions: Ensure that all claims are complete and accurate before submission to avoid delays or denials.
Follow-up on claims: Monitor the status of claims and follow up on any denials or delays. Claims tracking systems are the most cost- and time-efficient way of tracking claims statuses.
By following these guidelines, long-term care facilities and pharmacies can ensure their census data and claims processes are better aligned. Doing so will reduce the time and costs associated with retrospective corrections.
Third-party auditing services typically cost each facility between $500 and $1200 per month, however, some claims cannot be corrected if addressed too late and become excessive costs for LTC facilities.
Speak with one of our experts to learn how Clean Bill can lower costs and streamline billing operations for your LTC facilities or pharmacies.
By following these guidelines, long-term care facilities and pharmacies can ensure their census data and claims processes are better aligned. Doing so will reduce the time and costs associated with retrospective corrections.
Third-party auditing services typically cost each facility between $500 and $1200 per month, however, some claims cannot be corrected if addressed too late and become excessive costs for LTC facilities.
Speak with one of our experts to learn how Clean Bill can lower costs and streamline billing operations for your LTC facilities or pharmacies.
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Achieving a clean bill every month has never been easier.
Achieving a clean bill every month has never been easier.
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Founded in 2018, VistaRx (Vista) provides comprehensive pharmacy data capture and management solutions for a variety of entities in the pharmacy value chain. We utilize custom-coded technology, strategies, and partnerships to help our clients improve operations and reduce dependence on third-party vendors.
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SUPPORT@VISTARX.COM
(385) 355-4882
2290 E 4500 S, STE 130
HOLLADAY, UT 84117
COPYRIGHT VISTARX 2024
Sign Up for Vista Insights and Updates
SUPPORT@VISTARX.COM
(385) 355-4882
2290 E 4500 S, STE 130
HOLLADAY, UT 84117
COPYRIGHT VISTARX 2024
Sign Up for Vista Insights and Updates
SUPPORT@VISTARX.COM
(385) 355-4882
2290 E 4500 S, STE 130
HOLLADAY, UT 84117
COPYRIGHT VISTARX 2024
