Are you concerned with the number and amount of your medical insurance claims still unpaid after 120 days or more? If you are, take comfort that you’re in a large group of physicians and practice managers facing the same dilemma. Unfortunately, comfort does not equal payment.
Because of the multiple components involved in billing submission accuracy, payer claims efficiency and internal staff culture, identifying specific problems is challenging.
You can use the national average collection time periods as published by the Medical Group Management Association (MGMA) that appear in their annual survey of medical practices with different specialties. This data helps you evaluate the efficiency of your billing department, along with assisting your accounting staff in preparing your operating statements.
Breaking news: Receiving insurance reimbursements faster is a popular goal of all practices around the nation. Although a common practice objective, many physicians and practice managers become befuddled about how to accomplish this vital goal.
Identifying specific causes for reimbursement delays is difficult. Simply placing the cause on your billing department or third-party billing firm is the easy, but seldom, accurate answer. While billing staff errors or omissions may play a role, their performance often is not the most important answer.
Consider the following tips and suggestions to accelerate your insurance reimbursements. Getting reimbursements faster seldom requires major capital investment or expensive consultants. Some common sense and diligence will usually accomplish your goal.
5 Tips to Get Reimbursements Faster
- Streamline front desk operations. Busy practices create numerous distractions for your front desk people, however excellent they may be. While you are probably aware they are challenged by phones ringing endlessly, checking-in patients, checking-out others, getting and putting away patient files (remember HIPAA rules), all while entering patient personal and insurance information into your software. Your awareness, however, may not equal comprehension of how these distractions often delay insurance reimbursements. Since the accuracy of claims depends on the equal accuracy of patient information, the errors that occur—and they will—often delay reimbursements.
- Understand the filters of claims clearinghouses your payers use. The clearinghouses your payers employ use filters to verify electronic claims validity. If their filters identify a problem, some, but not all, will notify the practice with messages that also include actions to fix the problem. Understand how these clearinghouse filters work.
- Diligently follow-up claim submissions. Have billing staff follow-up all claims to ensure timely payment. Be particularly diligent with follow-up if you sometimes pull billing personnel from their stations to cover other short-handed departments. Billing and coding staff can forget to follow-up or simply lack the time.
- Design, use and update patient financial agreements. This is a commonly overlooked feature of getting timely reimbursements. Be sure you have signed, complete and updated agreements that give proper permissions to file claims and promises to pay all amounts insurance plans do not cover.
- Scan all EOB documents and coding sheets for fast retrieval. Busy practice staff can misplace EOBs, diagnostic and treatment sheets or suffer delays in putting them in patient files. Scanning these documents organizes them and makes for easy retrieval for billing staff to file or re-file claims.
These tips will speed claim reimbursements. They always work. You can improve the results by making another change.
Remove the patient information entry function from your front desk personnel. This change helps accelerate reimbursements because the delicate balance of their varied duties will not include this error-inducing responsibility. This action plan can be challenging to implement, but it will be worth the effort in faster reimbursements.
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