Where To Find Unpaid Claims (so you can get them paid)

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. ​

2.) EOBs and ERAs. Look for EOBs that have been set aside for follow up and for EOBs that have not been entered yet. These will contain denials that can (hopefully) be corrected and resubmitted for payment. NOTE: More often than not, I see offices with ERAs that get automatically entered into the software, resulting in services that get written off when they could have actually been corrected and the claim resubmitted. It's worth reviewing your past ERAs for claims that could have been corrected that were instead, overlooked. 

3.) Accounts Receivable Report. Once you've tackled the above and the EOBs and ERAs have been entered, now is the time to get on the phones and chase up those unpaid claims. There will be a portion the insurance company insists they "never received". These can simply be sent again and should get processed for payment. The rest you will need to get the information on and correct and resubmit as needed. 

In most offices, there is usually plenty outstanding that can be found and gotten paid. Doing this should help offset any temporary decline in patient visits that you may be experiencing.

If you need help with this or would like a free consultation, contact us here. We're here to help you through it! 

Yours in health, 
​Jessica Greenwood