Every year, your practice can lose hundreds to thousands of dollars by not efficiently managing insurance claims and denials. By reviewing some basic insurance billing follow up, medical collections and denial management procedures, your practice can reach its maximum revenue.
1. Regularly ask patients for insurance cards and make a copy to keep on file. Though it may seem somewhat tedious to request insurance cards from repeating patients, doing so ensures that your billing department has updated demographic information in order to have clean claims and denials on the first submission. Your front desk staff should make copies of the front and back of the card and attach it to the patient’s chart. This is also an opportune time to request and make a copy of the patient’s driver’s license or photo ID so that you have all information for your records.
If a patient does not have their insurance card with them and guarantees that their information has not changed, ask them to fax a copy of it to you anyway. Insurance carriers often change ID numbers or prefixes, despite coverage not having changed – and patients might not be aware of these small modifications.
2. Regularly work claims and denials or utilize a business process outsourcing company. The best way to ensure that claims are filed on time is to submit them as close to the service date as possible. Using an insurance follow up and denial management company is beneficial in helping to identify any denied claims so that corrected claims can be resubmitted in the most timely and efficient way possible. Insurance follow up and denial management companies also have greater capabilities to follow up with your payers to identify, address, and rectify any insurance problems so that your practice is able to work more productively while still increasing revenue.
If your practice has the ability to handle claims on its own within the billing department, it is critical to be aware of the filing deadlines for each of the different payers with which you work. Most payers have a timely filing limit, which can be as little as 30 days from the date of service. If you miss that date, despite your best revenue cycle management efforts, your practice might never get reimbursed for the services provided.
3. Make billing the only priority for your billing department. This may seem like an obvious statement; however, billers – especially in smaller practices – often have other responsibilities that prevent them from dedicating enough time to billing and medical collections. Although it may be more difficult for smaller healthcare organizations to designate staff and resources, your practice can still take extra measures in administrative and clerical functions to ensure that your providers are paid all money owed by patients and their insurance companies. Despite the size of your practice, allowing billers the time to ensure charges are accurate before posting them can have a significant increase on your cash flow and the greatest reward: higher collections.This information is not to be construed as legal advice. Legal advice must be tailored to the specific circumstances of each case. Although we attempt to provide up-to-date information, laws and regulations often change. We make no claims, promises, or guarantees about the accuracy or completeness of this document. For legal advice, please consult an attorney.