Auditing Your Patient Data

Keeping an accurate patient database can be one of the key components to accurate billing. Using an EHR to keep track of your patient data is an incredible tool, however there is still a level of human error in data entry. Every now and then it is a good idea to go through and audit your patient data to make sure that you have the most accurate and up to date information. What better time than at the start of a new year? This can make things easier for appointment scheduling, billing, and general upkeep of your database.

Identify Inactive Patients

The first step in auditing your patient data is to comb through your list and identify inactive vs active patients. If a patient is inactive, you can either mark them as inactive in your EHR system or delete them from your system. Our recommendation is to mark them inactive so that you do not lose any progress notes if the patient ever decides to come back. If you come across any duplicates or “tet patients” used for testing your system, you may want to consider merging the information for duplicates and deleting the test patients and empty duplicate files. This step will save you from updating the information for inactive patients.

Check for Missing Data

Once you have a list of your active patients, you should go through and check for any fields that are missing data in your EHR for each patient. You will want to have a current mailing address, email address, phone number, and emergency contact information in your EHR system. Once you have identified what’s missing, you can make sure to collect that information from your patient the next time that you see them, or send a request that your patient goes into their portal to fill in all of the necessary information.

Checking Insurance Information

Arguably most important for billing is to go through and make sure that you have all necessary pieces of information for insurance claims. The patient name, date of birth, their insurance ID number and group number, and the name of the insurance company should all be noted for every patient who uses insurance to cover their sessions. Often insurance coverage may change at the beginning of the New Year if an employer has changed the coverage that they offer for their employees. It is a good idea to confirm new insurance information with all patients the first time that you see them in a new year. We also strongly recommend that you keep a copy of the patient’s insurance card on file. This way you have a reference to double check the data entered into your EHR system if you run into errors with claims processing. Sometimes the issue is as simple as a typo!

Review Demographic Information

Demographic information for your patients is also important for billing. Their address is used in claim submission, as well as date of birth. You may have patients who had been on their parent’s insurance policy, but have aged out and should now have their own policy and their data will need to be reconfigured to reflect that they are the insurance policy holder, not a parent. You also may have patients who have legally changed their names for a variety of reasons. It is important to make sure that the data you have in your EHR matches whatever the insurance company has on file. Completing Eligibility & Benefit checks can help you in identifying what information you should have in your system.

Check for Spelling Errors

Entering data into a system can yield errors, and some insurance claims may deny if you don’t have the correct spelling of a patient’s name or street address. Going through your system and checking for obvious spelling errors is a good practice to do every so often to make sure that your claims will process correctly.

Auditing your patient data can be a time consuming process, but in the long run it can make billing run more smoothly! Knowing that your database is as accurate and complete as possible can be extremely helpful in getting claims to process cleanly. While Practice Solutions does not offer complete audits of your patient database, we do complete eligibility and benefit checks as part of our billing service. These checks can help to maintain the proper information in your system. If you are interested in connecting with a biller, reach out to us today for more information!