I also redact patient info prior to uploading documents

To come up with a more streamlined end of month closing. It seems I get so tangled up in the day to day business that I’ve been setting aside the end of month close until I looked at my lander and realized it was the 12th. My goal is to have it closed and invoiced by the 5th. I’ve decided to entrust the close to a qualified team member but ensure that nothing gets invoiced until I approve the close. This way I quality control it and get it closed in a timely fashion

1 in San Diego that is a multispecialty (Vascular surgery, podiatry, and wound care. Vascular was the hardest specialty of my career to learn, so many different veins that attach to other veins, etc.) They have 6 offices with 8 practitioners (2 are part time) 2. in Florida they are a general practice with 3 providers. They are actually acquiring another practice, also general practice, and will be adding another contract with me. But my hope is that one of the owners has a brother that has a Urology office in Georgia that brings in 3 million revenue a year, and he says he would love to set me up with his brothers office when I am ready. 3. A Nurse Practitioner who just finished school, she has been doing medical home care, ALF's for years, but she went to school to add mental health to her practice. She has opened her own practice, and as soon as her credentialing is complete I will be running her RCM remotely. Both medical and mental health. I specialize in wound care, mainly with diabetic wounds. The use of skin substitutes (skin grafts) Last year these wee very lucrative, and a average doctors claim was between $60,000 and $95,000 a year. However doctors were afraid of using the AMAZING treatment that would heal an open diabetic foot ulcer, even one that had been open for more then a year in a once a week 12 week treatment, however, the compliance in documentation was grueling. CMS would come back a year to 2 years later and demand an audit on patients what had this treatment, If the doctor did not put something as simple as "conservative care" in their note (Even though it is in the record, but not in that visit note) that visit would be deemed Denied due to NOT MEDICALLY NECESSARY, even though the doctor would measure the wound, take photos, and every week the wound would get smaller and smaller, and measure smaller, clearly it was medically necessary and the patient was benefiting, but because of the progress note missing such a small piece of the puzzle (that the record had in it) BAM stamped NOT MEDICALLY NECESSARY, we want our money back. Now the supplier has been paid, the patient is healed and its been over a year, who is stuck with the takeback? the doctor of course, so he or she now owes CMS 500-700 THOUSAND DOLLARS, tell me that is not going to put the doctor out of business. the doctor probably only made about $10K on each 75,000 claim (supplier got most of that check). I did audits with these doctors, helped them addendum their notes, went through an audit where the provider was ordered to pay....... 1.7 million dollars back WHAT!!!!!!!!!!!!!!!!!!!!!!!!!!!!! I recommended she hire an attorney, enter the addendum, when we finished rewriting her notes, she only had to pay back approximately 5,000. This is what brought me to building my AI, to fight back these dirty insurance companies.

Sorry for the book ya'all

Thank you, I have been outsourcing my credentialing to a gentleman in pakastani, he is quiet good and only charges me $125 and application, I charge my clients $250 an application, so there is a profit to be made and all I have to do is gather the information he requires. However, it is something I have been wanting to learn to do on my own, thank you for this checklist

@Tesheryl Wheeler Thank you for your words, and thank you I will take you up on that

Hi! I'm Deanna. I've spent the last 24 years in medical billing and coding, and last year I took the leap to start my own Revenue Cycle Management company. It's been an incredible journey—I've already grown to three accounts (one in California and two in Florida), and I've just brought on four externs from the AAPC. I'm training them with the plan to hire two full-time. Right now, I'm working on something I'm really excited about: an AI platform designed to catch denials before they happen. It validates medical necessity, checks ICD-10/CPT/modifier combinations against payer requirements, and flags issues that would otherwise slip through. Basically, it fights denials before the claim ever leaves your door. Honestly, this company has become my life's work. I'm building something my children can step into and grow. I work constantly because I love what I do—and I'm good at it. I can look at a claim for five seconds and tell you exactly what's going to stop the payer from reimbursing. That's my superpower, and I'm putting it into this company. check out my website www.propracticesolutions.com