Errors commonly occur in the routine reporting of codes to the health insurance company and doctors lose a lot of money as a result. In a recent webinar, Ondřej Sobotka, MD, discussed ways to make reporting codes to health insurance companies easier.

How practices are losing money

Practices routinely use more than 90 different codes when reporting medical procedures per month . So it's not uncommon for some to be forgotten. According to MUDr. Ondřej Sobotka, this is a big problem - practices lose money from insurance companies.

If you are interested in our webinars, please email us at podpora@sestraemmy.cz.

Who can report codes for a practice? As a rule, you will encounter four possibilities:

• Codes are reported by the nurse,
  
• codes are reported by an external staff member,
  
• codes reported by the doctor himself,
  
• the codes are automatically reported by the software.
  

The first three options have several disadvantages. "There is a human factor at work here . The moment we rely on a worker, we are 100% losing money because they forget to report the codes," says Dr Sobotka. The doctor also pays for the work of the person who reports the codes - a time-consuming activity. Therefore, according to MUDr. Sobotka, the ideal solution is to use software.

The key is properly set up software

Set up your outpatient system correctly for easy reporting. As a result, you don't have to think about anything - just work routinely in the outpatient system, which automatically reports the codes for you.

Standard outpatient software should allow you to create so-called phrases that are linked to one or even a combination of procedure codes. With phrases, the physician saves time not only by writing repetitive formulations, but also by writing codes. Above all, the forgetting factor is eliminated.

The outpatient software also allows the reporting of the code when an external device, e.g. an ECG, is started. You just need to know about this functionality and ask the software supplier to set it up.

Which procedures are worthwhile?

In the last part of the webinar, Dr. Sobotka discusses the classification of codes into different groups:

• capitated procedures,
  
• obligatory procedures,
  
• and two groups of elective procedures.
  

Don't waste your time with the codes that are included in the capitation. "Capitated procedures, although we can report them to the insurance company, we no longer get reimbursed for them. They are included in the capitation. We don't have to report these codes and let's not do it, it's extra work, " advises MUDr. Sobotka.

‍"Then there are the obligatory procedures, which are available to all GPs, and which we report over and above the capitated procedures. With their help, we can earn extra money and improve the economic performance of the practice, " explains MUDr. Sobotka.

In the case of elective procedures, additional equipment needs to be purchased for the practice. Nevertheless, this investment is worthwhile and can easily increase profits. We therefore highly recommend contracting them. Just beware of the second group of optional procedures, F2, which may be subject to additional rules by the insurance company - for example, completion of a specialist course.

We will advise you in the webinar

By setting up your reporting software correctly, selecting the appropriate procedures and equipping your practice, you will achieve the following:

• You will have more time for your patients and yourself,
  
• reduce the risk of burnout,
  
• save costs
  
• and make more money.
  

For a recording of the webinar with Dr. Sobotka, email us at podpora@sestraemmy.cz. It's free, you'll discover helpful tips and learn answers to problems physicians commonly face in their practice.

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