How to Improve Patient Collections – Part 2

Improving patient collections starts before you ever treat the patient. The next step to better patient collections is improving your verification process.

Good insurance verification is vital to any practice. I recommend that our clients verify patient benefits at the front desk if possible – rather than outside the office –  for a number of reasons. Entering time and distance into it increases the chance that services performed aren’t going to be covered. If a patient has a policy update and tells you at the last minute, coverage can then be verified in your office immediately, while the patient is there. And explaining benefits to a patient – what should be covered and what they may owe –  is easier to do when the patient is right there with your staff. In any case – whether you do verification in your office or have them done remotely, let’s see that they are done well.

• Ensure that you have a good verification form to use, with a box to check or a blank to fill in for all the details you will need, so that nothing is forgotten.
• Online verification – does it provide all the information you need to make sure that your treatments will be covered? If not, make a phone call to get the full coverage information. This can be more time-consuming, but worth it in the long run.

There is a lot of detail to good, thorough verification. Here are ten of the items that will help:

1. In network or out of network? Make sure to ask for the correct benefits. If you don’t, the person on the other end of the line may quote you the wrong information.
2. Ask for deductible amount, out of pocket max, family deductible, family out of pocket max, and amount met on these items.
3. Co-insurance %? Does it change after the deductible is met?
4. Does out of pocket max include deductible? Do co-pays apply to deductible?
5. Benefit year – calendar or anniversary? From when to when?
6. Office visits – co pay amount? Coverage %? Subject to deductible?
7. Is your specialty specifically covered? Any restrictions?
8. Is prior authorization required? What is their authorization procedure?
9. Is there a limit to number of visits or specific treatments in the coverage period?
10. Specific codes which are most often performed – ask about them. Are they covered? Are there any limitations to their coverage?

Ensure that the person doing the verification in your office understands the insurance process and the words on your form. Make sure that they have the time to do them and know the importance of thorough verification to the success and well-being of the practice (which ends up in their paycheck!).

Give us a call. We are always happy to chat with you and be of help if we can be. In my next newsletter, we’ll talk about how to set things up in your office to improve patient collections even more.

If you missed the first installment on How to Improve Patient Collections and would like to read it, please click here. 

Have a great week!