Medical Billing- Be Vigilant about Decreasing Your Receivables

Medical Billing- Be Vigilant about Decreasing Your Receivables

There are too many delays that can prevent timely reimbursement for your claims. This, of course, causes cash flow problems. You may be able to avoid them by reviewing your process at the following touch points and making adjustments, where necessary:

Pre-registration

If you have this in place, you can even obtain information when the patient first calls for scheduling. This would include insurance information so you can verify it. You could also get the SSN, driver's license number, etc. That way the information is securely in your EMR system.

Patient Visit

Make sure you get good copies of the insurance cards. Review your form to make sure it has been thoroughly completed and includes a thorough financing statement. This needs to include when payment is due, late fees, and any interest that will accumulate on the uncollected balance. In addition, you might also detail:

No-show fees

Prescription refill costs

Return check fee

A fee if the co-pay is not made at the time of service

Make sure the patient signs it. Make sure that they remit their co-pay or prior balance before they leave. If they cannot, have your staff note why the patient wouldn't or couldn't pay.

Completing Claims

Medical coding and posting charges to the claims needs to be done in a secure, quiet location. The tiniest error could cause the claim to be denied. You want to shoot for 100% compliance in this area.

Submitting Claims

When you submit the medical claim, it goes to a clearinghouse. Some of the more prominent ones include PayerPath, RealMed and Emdeon. All of them go through at least a cursory look at the submission to make sure everything is present. Some may do a more thorough job than others.

Make sure you respond to their request for correction within 48 hours at the very latest.

Checking on Payment

Insurance companies are not going to suggest that you use a system for making sure a claim is paid in a timely manner. Establish a reliable follow up system based on the contract and stick to it. Make it efficient. You can usually follow up and obtain statuses on line. Take advantage of that. It will be better for your office if you can check on 20 claims online in the time it takes to check on two via the phone.

Finally, if the payments are too slow, make an appointment with an insurance company rep. Make sure they are living up to the contract.

Reporting

Whatever system your are using, make sure it has the flexibility to measure the usual numbers (average days of receivable in 30 day increments, total receivables, amount and percent collected, etc.). Make sure it can do ad hoc reports for you, too.

In fact, if you are seeking a medical billing company to do your billing and collecting for you, reporting needs to be one of their strengths.

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