Rock-Pond Solves Timely Filing Problems

Submitting a claim by a payer’s timely filing deadline is essential to running your business successfully. If you submit your claim late, the payer will deny payment on it. Rock-Pond can help you avoid this problem with their timely filing reports for HomecareNet and CPR+.

These reports recently made it much simpler for a Rock-Pond customer who uses the CPR+ system to submit claims in a timely manner. Rock-Pond’s timely filing reports gave them a list of timely filing deadlines for their active insurance companies and gave them detailed reports that showed their unbilled tickets and invoices in their A/R with the reason it hadn’t been billed and the amount expected from each claim.

The company’s director of operations said that while CPR+ has some good tools, the Rock-Pond reports she uses gives her greater detail that allow her to group her information how she needs it.

“CPR+ is great because it will highlight in red if something is timing out, but [the Rock-Pond report] will tell you exactly how much time you have and I think that’s so much better,” she said.

Thanks to Rock-Pond, this customer was able to gain access to the information she needed from the data she had and automatically analyze how her company was doing with filing claims in a timely manner. If you’ve had a similar success with these reports or would like to know more about becoming a Rock-Pond customer in order to take advantage of these reports and many others, contact Rock-Pond today.

What happens when your patients turn 65?

65 is a milestone year for Americans.  Among other things, it is when we are eligible for Medicare.  When the government gets involved in anything, everyone needs to pay attention.  Taking proactive steps before your patients turn 65 will save you a lot of headaches and reimbursement problems.  Rock-Pond Reports provides a simple report that will keep you on track.  Here is how it all happened:

Rock-Pond received a call from a customer whose billing department began receiving denials for claims for long term patients whose claims were consistently paid on time.  After research they determined that the sole cause of the problem was the patient turned 65 and Medicare becoming their primary insurance.

After researching denied insurance claims they realized they were related to Medicare paperwork not being completed; even the patient was not 100% sure what to do.  Past due accounts mounted and cash goals were at risk because of insurance denials that were queued to be called on.  Although simple to prevent with advance notice, by the time the denials started coming in, many incorrect claims were in process and the provider was in a vicious circle of denials, past due accounts, phone calls, insurance verification and re-billing.  If they had known ahead of time when their patients were turning 65 all of this could have been prevented.  This is why they called Rock-Pond Solutions.

Rock-Pond Solutions created a simple report that included Name, DOB, Gender, Phone, Status and current insurance provider to identify patients turning 65 within the following 60 days.

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They now run this report each month to eliminate the guess work or individual searches to determine Medicare eligibility based on age. By using this report they were now able to proactively address the “age 65” issue before the first claim went out and save hours of work and headaches caused from unexpected denials, collection calls and re-billing.  Cash flow is up, employees are more efficient and patients are more satisfied.  The provider submits each claim confident that they will not get blindsided by a patient turning 65 without them knowing it.

Thanks to this provider, all Rock-Pond Reports customers are able to use this report as a part of their ongoing business processes.

A/R Adjustments – made EASY

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It’s bad enough that you have to adjust off accounts receivable. This is money that you have booked as revenue and counted on receiving. In most home infusion companies the adjustment process is a manual process of filling out an adjustment request form, getting it approved by a manager, re-looking up the invoice and applying this adjustment. The end result is a lot of errors, overstated A/R, wasted time by collectors calling on invoices that should have been adjusted, etc.

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Rock-Pond Solutions worked with one of our customers to create a report that streamlined the process whereby the collector or cash posting clerk would make the adjustment according to predefined procedures. The manager runs the Detailed Adjustments with Invoice Status report each day to review the adjustments from the prior day and either approve or reverse them with notes in the system to the collector. The results included time savings, improved accuracy, elimination of paper, improvement of audit trails in the system and a much better understanding of why A/R was being adjusted in the first place so it could be prevented. If you are using the CPR+ software and are not using this report – call us right now and we’ll show you what it looks like with YOUR DATA.  If you are using HomecareNET or Ascend, call us and we’ll write this report for your software.  No matter what you are using, you need this adjustment report and it doesn’t come with your software.