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Missing Accession Audit Process

Author: Diana Brooks, Regional Business Development Manager
Posted: 14 November 2012
Copyright: (c) 2012, PathologyOutlines.com, Inc.

A crucial step to optimize collections and avoid leaving money on the table is to verify that all cases performed are submitted for reimbursement. A detailed accession or patient encounter audit process ensures that every case is received and filed with the insurance carrier. This process gives the practice or billing company the ability to track, report, analyze and monitor cases to certify that all claims are billed. The process works on a system of checks and balances- much like a bank account.

Each unique case identifier should be tracked monthly on a 30-45 day lag from the date of service. This process should be monitored by a dedicated employee in the billing office who can generate client specific tracking reports.

The client reports produced from this tracking process will show any gaps in an accession sequence, thus allowing practices to have a monthly list of missing accessions. This report helps laboratories verify if a case has truly not been billed or if there was a specific reason as to why a case wasnÕt submitted (i.e. inconclusive testing, canceled case, skipped accession).

While reporting is essential, the most important part of this process is the analysis of the report by the billing provider and corresponding follow up with the laboratory. This research aids in the retrieval of missing or incomplete data. A requisition may have been received for an accession, but not the accompanying report, or vice versa. This provides billers the opportunity of performing an audit to assist in the recognition of trends appearing on the front end of the billing process.

It may take longer than 30 days to reconcile the report; therefore a running list of all missing accessions should be logged, the date information was requested, and when, if applicable, the case was then billed. Accessions still missing from previous months should be added to the current month's missing accession list, ensuring that no case is abandoned. This accrual process gives the flexibility to follow up on missing accessions on a case by case basis, making sure that every case has been worked to its fullest extent and, in turn, leaves no money on the table.

PSA specializes in pathology and clinical laboratory billing, marketing, and business support services. For questions related to this topic or to learn more about PSA, please visit www.PSAPath.com or contact Leigh Polk at 1-800-832-5270 ext. 2941 or lpolk@psapath.com.