Often, when I am reviewing a client’s medical receivable, I notice revenue lost simply because steps were not taken on the front-end that are necessary to secure payment and maximize collections. In some cases, if a few initial steps are not taken on the front-end, there is nothing a biller can do to get a claim paid…the ship has sailed. Fortunately, these mistakes can be avoided by following a few simple steps:
- Make sure to collect a patient’s copay prior to their visit–this may seem obvious or perhaps “no big deal”, however, some insurer’s payment is the copay alone and no further reimbursement will be made. Failure to secure this cash upfront could mean that you will not see another dime for this visit
- Check to make sure a patient is truly eligible with their insurer. Some patients may not even be aware that their coverage has been cancelled, others may try to be seen without insurance. It is too late to collect payment once the patient is out of the office.
- Check to see if an authorization is necessary for this patient’s visit. Insurers are routinely making policy changes that you may not have realized; all it takes is a quick phone call to be certain.
- Get a copy of the patient’s insurance card, front and back. This is your insurance to make sure there weren’t any keystroke errors during intake, or, to be certain that there isn’t a different phone number for a patient’s particular policy.
- Check prior visits to be certain there are no outstanding balances due. Perhaps the patient owes coinsurance or a deductible has been applied to your visit. A patient is more likely to pay their bill when they are standing in front of you, as opposed to when they receive a bill in the mail.
You might think that these steps are all obvious, however, I assure you they are not. Furthermore, one may not realize these are necessary steps, unless you are familiar with the billing process. Your front-end staff is not only there as a smiling face to greet patients, they should also be looked upon as a conduit between the patient and the biller. If steps taken during intake are done haphazardly, your bottomline will be affected. Share these with all members of your staff, so that you can feel confident that you are maximizing your collections.
This is great practical advice that can be applied to all industries! It may not seem like a lot of money if one $30 copay is missed, but what happens if you miss one $30 copay per week? $1,560 is lost never to be recovered.
As you point out so well profits can be lost without the proper processes in place. I teach my clients the same thing; get the information and training to the people doing the work. Protect those profits!
[…] (function() { var s = document.createElement('SCRIPT'), s1 = document.getElementsByTagName('SCRIPT')[0]; s.type = 'text/javascript'; s.async = true; s.src = 'http://widgets.digg.com/buttons.js'; s1.parentNode.insertBefore(s, s1); })(); TweetSharehttp://stacyluft.com/?p=25EmailMy friend Susan Baylis at Medical Account Solutions lays out some important points of lost profits in medical office billing processes in her blog “Maximize your medical receivable with a few simple steps”. […]