Charge Capture Tool

An Excel spreadsheet that helps a practice conduct a chart audit to determine whether it is billing and getting paid for the appropriate services.

Download Format: Excel

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Claim Correction Form

A one-page form that can help make the process of filing corrected claims more efficient

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FPM Superbill

A superbill to capture the codes most common in office-based outpatient practice

Download Format: Excel

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ICD-10: HCC Coding Reference for Family Medicine

A coding reference tool listing common diagnoses and the HCC weight for each one

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Letter to Health Plans About Same-Day Wellness and Illness Care

A sample letter to health plans about the inappropriate bundling of preventive medicine services and problem-oriented E/M services on the same date

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Medicare Superbill

A superbill to capture the CPT and HCPCS codes most commonly used in office visits with Medicare patients

Download Format: Excel

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Patient Financial Agreement

A patient agreement outlining a practice's payment policies, including how to handle co-pays, insurance deductibles, payments plans, and overdue payments.

Download Format: PDF

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Patient Financial Hardship Application

An application for patients facing financial hardships and seeking assistance from their doctor's office to pay their medical bills

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Screening and Assessment Coding Reference

Descriptions of each code and examples of standardized instruments that may be used for screening and assessment services

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Skin Care Encounter Form

An encounter form for rapidly and accurately coding skin-related diagnoses and associated procedures

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