Reimbursement spreadsheet is a virtual financial tool that can be used to show and discuss the patient’s cost of care. It also helps in reviewing the past payment history of a particular healthcare provider. For a reimbursement analysis to be effective, it should have certain aspects such as:
The analysis must indicate the cost of services rendered by the healthcare provider in reference to the patient’s current health condition. The primary objective of this analysis is to give the correct information on how much a patient is paying for each service rendered. If a medical billing company or health insurance company requires an analysis to verify whether it has violated its rules, the reimbursement spreadsheet must contain the details about the past billing history of the organization.
Factors That Must Be Considered In An Effective Reimbursement Spreadsheet
Reimbursement details should also include the date, procedure and the name of the service provider. A correct analysis should show if the provider does not charge the correct amount for each service rendered or has charged more than what was paid to the patient in the past. This is the most important criterion for a payment analysis.
The calculation of the charges of services for both the hospital and the provider should be done without any errors as to provide accurate information on the service being rendered. The analysis must have accurate information about the patient’s medication.
The review of the past billing records of the healthcare provider must be done by a highly professional and reliable private industry. Only a professional audit team must be hired in order to review the past record and pay the appropriate payments to the patients.
The study should focus on the patient’s past medical history, including his family medical history. It must also include the patient’s prior utilization of the healthcare provider and the prescription patterns of the patient’s drugs.
The analysis must show the exact amount of the payment that the patient has been receiving for his total healthcare costs. This analysis will show whether the reimbursement contract is in good standing or if it needs to be renegotiated for better rates.
The company should have an accurate calculation of the bills that are being sent to the insurance companies for reimbursement. All the payments should be included in the reimbursement spreadsheet for the patient’s review.
Reimbursement comparisons should be made with the service provided by the healthcare provider’s payment history. This comparison should be done with all the providers in order to get a clear idea about the different services rendered by the provider.
The review of previous payment should be done to show if the provider is charging the correct amount for each service rendered. The complete history should also include the service charges for the services rendered by the provider in the past.
It is important for the audit team to analyze the reimbursement history of the provider so that the patient can know his or her correct payment amount. The provider should also be evaluated with the accuracy of the health plan in the past.
Once the provider has been found to be working in an efficient manner, it is necessary to complete an accurate account of the payment with the proper documentation to the appropriate insurance provider. The staff of the physician must be updated on the payment details every time a new bill has been received. LOOK ALSO : recruiting spreadsheet
