If the worry over COVID-19 has caused your patient visits to drop, or if you've opted to close your office, it is a good idea to jump on your unpaid claims and get as much paid as you possibly can. Here are the three places you should look for unpaid claims:
1.) Clearing house denials. Somewhere in your clearinghouse interface is an area where all of the claims that had errors and could not be processed, sit. Start here and look as far back as you can go. Sometimes this area gets missed by a bogged down billing department. NOTE: Claims that are stopped here have never made it to the insurance company and are subject to the timely filing deadline. Get these claims fixed and resubmitted as quickly as you can.
Front desk collections are a key component of a profitable healthcare office, yet, they are often one of the most overlooked areas. Many offices rely almost solely on insurance collections, often overlooking patient collections.
When done right, patients are easy to collection from. I'm going to show you how I walked into an office and within two weeks, had 10xed their patient collections WITHOUT increasing new patients.
I know, looking at those numbers is your A/R report makes you feel a little sick to your stomach, right? Don't worry, we can get it under control and get it collected. I'm even going to tell you exactly how to get it done. Ready? Here we go...
A EOB backlog can be a potentially devastating problem for your practice.
It seems innocent enough, it's just a stack of paper, right? The claims are already processed, you can just go through and pull out the denials and fix those, right?... RIGHT???
I hate to tell you but, no. A backlog of EOBs is much worse than that. Here's why:
We've all had it happen, you hire a GREAT employee. Great resume, has the experience and seems really willing to be a team player. Things start off ok, maybe some hiccups here and there, but that's normal of a new employee, right?
Yet 3 months, 6 months, 9 months down the line things STILL aren't smooth. Mistakes are being made and your once seemingly willing employee now seems overwhelmed, a little beat up and cranky.
Calling the insurance companies to follow up on unpaid claims is painful and frustrating. In my opinion, it is quite possibly one of the most frustrating and underrated parts of working in a clinic. However, it is also the most remunerative.
The reason is simple. For the purpose of this article, let’s assume insurance companies bank on the fact that it is so painful and frustrating. Let’s assume they KNOW you don’t want to call. That they KNOW you don’t want to stay on hold for several minutes only to speak to some relatively unpleasant person who then proceeds to tell you you’ve called the wrong department and that no, they won’t transfer you. Let’s assume they know you are busy and they know you have patients coming in and out of the office that have to be tended to.
When you are running an office, what is your biggest investment? Is it your equipment? The office space itself? Your patients?
While all of these rank fairly high on the scale of things, the answer to all of these is a resounding, "NO". Your biggest investment is your staff.
Think about it. How much money do you spend a year on staff? Better yet, what would happen if your entire staff got up and walked out right now? Sure, you can replace them but at what expense? Training a new staff member is costly, in both time and money.
In my experience, there are 4 main reasons an office should use a billing service. They are:
You are opening a brand new office and are not ready to invest in software of your own: Practice Management software can be costly and I find that a lot of start up offices prefer to start out by using a billing service to take care of the billing for them. This allows them to focus their attention on growing and handling the brand new business
Jessica Rose Greenwood
Jessica is the owner of JMK Billing, a Billing Specialist and expert in office management