Last Modified: 1/18/2018 Location: FL, PR, USVI Business: Part A, Part B
“I feel the site gets better each day. And it’s all free. I get so much out of using it.”
Allison Wakeland uses the self-service tools on First Coast’s website throughout her work day at NeuroSpinal Associates and the RiverWalk Surgical Center. (Photo Courtesy: NeuroSpinal Associates)
Click here and tell us about your success story with First Coast’s web tools.
Enthusiasm for web tools puts surgery center at cutting edge
If you were to talk with Allison Wakeland about the First Coast Service Options’ web self-service tools, she sounds much like a home shopping network emcee. She talks up the benefits with each Web tool with such enthusiasm, you want to reach for your Visa® card and buy one right away.
Fortunately, for health care providers who service Medicare beneficiaries, these tools are free. And NeuroSpinal Associates, a physician group in Bradenton, FL, and the affiliated RiverWalk Surgical Center, bank on Wakeland’s enthusiasm in using them.
Wakeland leads the Medicare billing efforts for the group of surgeons and pitches in to assist with filing facility claims as necessary. In making sure claims are filed timely and correctly, Wakeland has become a super-user of the First Coast web tools.
She bookmarks her most-used pages and cites a business use for each of the 15 tools available on the site. “I’m in the fee schedule and LCD lookup tools each day. The site stays up on my screen all day because I use them so much,” Wakeland says.
“The LCD lookup is really helpful with medical documentation. The LCDs help us educate doctors on what they need to document. It provides a great deal of detail. I will show the doctor the LCD and review with them what they need to document in the way of diagnosis codes,” she added.
The ambulatory surgery center and affiliated physician office process more than 300 claims a month. Seventy percent of their patients are Medicare beneficiaries, with nearly a third of those patients enrolled in Medicare Advantage plans. Because of these numbers, NeuroSpinal Associates and RiverWalk need Wakeland to stay on top of the changes in Medicare billing.
“It might take 30 days or more to find out we filed a claim with the wrong payer. This delay can add up quickly,” Wakeland says. “The patients don’t always know they’re covered by an advantage plan. Often, they tell us they’re enrolled in Medicare.” Wakeland says checking a patient’s secondary payer status and Medicare eligibility through First Coast’s Secure Provider Online Tool (SPOT) has greatly improved office operations.
Several of the First Coast web self-service tools include integrated features that allow providers to see important information through multiple channels. For example, when Wakeland reviews the fee schedule for a particular procedure, she can click over to the associated LCD document if one exists.
The fee schedule lookup tool offers a drop down window for providers to review if filing the claim requires any modifiers. “We check to make sure modifiers are applicable to the CPT® code the doctor is billing,” she says.
The modifier verification and the evaluation and management interactive worksheet play important role in the office’s compliance efforts as well. “With the evaluation and management worksheet supporting their billing, Wakeland says the billing team uses it to verify codes dictated by the physicians. “I will have the worksheet up on my screen as I run through what the physician has dictated,” Wakeland said.
In addition to the practice of filing clean claims, Wakeland says the tools play a critical role with quality improvement in their offices. She uses provider data summary (PDS) reports to evaluate claim returns. Besides spotting trends in claims processing, Wakeland says the PDS reports are helpful in identifying where her office staff might need additional training. “If we see a list of codes getting missed on a regular basis, I can call up the spreadsheet to see who is entering those codes and come back and train behind it,” she said.
Wakeland also takes advantage of the online and in-person training opportunities offered by First Coast. She attended the Medicare Speaks seminar in Orlando and listens in on most webinars. “Once I get my certification in medical billing, I intend to take full advantage of the CEU credits available through First Coast University.”
When asked what she would say to her peers in other medical practices, she says, “I feel the site gets better each day. And it’s all free. I get so much out of using it.”
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.