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.
Let’s also assume they also know that it is for these reasons that you most likely will not catch the “errors” made on your claims.
It is for this reason that insurance follow-up is so key.
I myself look at it like a treasure hunt. In my head, the insurance company is hiding money and it’s my job to find it.
And TRUST ME, it can be found.
There are a few tips that will help you on your hunt and I’m going to go over them in the next few blog posts.
Here is the first:
1.) Always, and I do mean ALWAYS, be nice.
It’s true that you catch more flies with honey and the same rule applies to dealing with insurance companies. Believe me, I KNOW how difficult talking to them can be. I know how unbelievably rude some of them (not all) can be and I know how tempting it is to snap at the unwilling and snippy person on the other end of the line after you’ve just spent the last 20 minutes on hold. But whatever it takes, refrain from snapping back.
The reason for this goes beyond manners and human decency. The reason for this has something to do with walking a mile in someone else’s shoes.
Have you ever imagined what it must be like to work for an insurance company? I’ve never worked for one myself but I’ve heard stories from those who have and frankly, it sounds like a nightmare filled with improperly denied and “misplaced” claims, cranky callers and the unshakable thought that you have something to do with an in-need person not getting the medical care that they need.
In my own experience, I have actually had insurance company employees go above and beyond for me for the simple reason that I was NICE to them. They gave me extra help because I WASN'T mean or rude and didn’t treat them poorly.
I can only imagine what that says about the other callers and things they deal with through out the rest of the day.
And, again, before you write this off as simply a rule of morality and human decency, it will also increase your collections.
I have been given direct fax and phone numbers, had my unpaid claims brought to a managers attention without my having to ask for it and had patient notes and forms escorted through and overseen to ensure they made it in the system and my claims were reprocessed all because I was nice to the person on the other end of the line.
I asked them about their day. I did not let out an annoyed sigh when their computer froze and I had to hold, I commiserated with them over a need for more coffee on a Monday morning and I genuinely thanked them for their help.
It’s important to remember that, while the insurance company can feel like the “enemy” when it comes to being paid, the person on the other end of the line when you call can be your ally. And when they are working with you instead of against you, you are far more likely to get those claims paid.
Jessica Rose Greenwood
Jessica is the owner of JMK Billing, a Billing Specialist and expert in office management