The Front Desk in your office can either make your practice, or break it. Why do I say this? If they don’t gather the needed information, then submitting claims with old information makes it so you don’t get paid by the insurance companies. At that time, the front desk people will no longer have a job because your practice will be financially hurting.
Why do I bring up your Front Desk? Because we have seen with many of our clients that the front desk is being trained on how to do things in the manner they were done in the early 2000s. Those processes are no longer working. Everyone is trying to save money (especially the insurance companies) and are shortening timely filing limits. Then there is also those insurances that let the patient change their plan every 30 days. Add to that many insurances are requiring more referrals, prior authorizations, etc. in order to make payment. Even primary care doctors are being hit by this denial.
The process that needs to be followed for the best performance for proper reimbursement is as follows:
1. When the patient calls for an appointment complete initial registration or review current information on file. This is a must. Listed in the complete registration process is:
a. Name
b. Date of Birth
c. Address
d. Cell phone
e. House phone, if they have one
f. Email address, if they have one
g. Current/Active insurance information
2. Many insurance companies will now give you lists of those procedures that MUST have a pre-authorization or referral. That needs to be reviewed and then if needed, the front desk should call the insurance company to start the pre-auth process.
3. When the patient comes to the office, all information needs to be verified by getting copies of the driver’s license (or other government ID), the insurance card(s) both front and back. This helps to make sure that when scanned, numbers that may have been transposed or mistyped can be corrected and the claim will go through quickly and correctly.
4. Don’t forget to get all the signatures needed, in order to keep HIPAA happy as well as the insurance world. These would include but probably not be limited to: Assignment of Benefits so you get paid; Financial Policy; Patient Privacy Policy, etc.
After the clinical portion of the visit please be sure to have all needed information about the charge into the hands of the billers. Sometimes this takes longer than 24 hours, but with insurance companies getting more and more stringent on their timely filing limits… Sooner is Better than later.
The majority of issues we deal with, over all of our clients are:
1. Incorrect Insurance Eligibility Information
2. Taking/Not taking correct copays
3. Insurance cards not copied front and back
4. No pre-authorizations
If you’d like to discuss more ways to be sure to get the proper reimbursement, quickly; we are always available.
