Over the past few months I’ve been writing about patient collections and what can be done in an office to help improve on them. Looking at EOBs and keeping payments up-to-date is the next thing I recommend. It’s easy to get behind. Offices get busy and this may not seem as vital to the revenue cycle as long as those checks are coming in.

If your EOB entry is not up-to-date

• Billing software won’t give accurate reports. With the Accounts Receivable numbers out of date, it’s hard to tell if the biller is doing their job well or if help is needed. Is the 30-day A/R higher than it should be? Is the 60-day A/R growing dangerously? What are the problem areas? With EOBs current, the information needed to manage the billing is there and can be counted on.

• Patient statements can’t go out correctly. Unless the front desk knows exactly what a patient is going to owe at the time of their visit, the practice is depending on those EOBs to come back showing what patient responsibility will be. Correct patient balances means increased likelihood that they will pay.

• Billing problems can be missed for far too long. Some denials come back due to simple billing errors which could be rapidly corrected. Other issues that need a biller’s attention can be missed entirely when EOBs are out of date. A biller should be on top of handling those problems to keep the overall A/R low.

• An office staff can waste time researching, discussing and following up on claims that have already been paid or responded to, which gets expensive in office resources. When EOBs are kept current, everyone is in the know.

For many practices, this is standard operating procedure. For many, it’s an area that suffers. I highly recommend that EOBs are collected at least weekly from every place they come to you, and are properly entered into your system, with any payment issues tackled from there.

If you missed the earlier articles on improving patient collections and would like to check them out, please click here to visit the blog page of our website. As always, I’m here to talk about your billing issues. Give me a call!

Have a great week!

Kat Jordan is the Owner of Orion Billing Services, a professional external billing company. With extensive experience in healthcare billing, Orion is well prepared to help with thorough, knowledgeable claims submission, follow-up and collection.
Call (415) 851-1605 for more information. 

www.OrionBilling.com

Talking with doctors about their billing troubles is always inspiring.  A conversation I had with a doctor today inspired this offer that I want to extend to you.

Here’s something that I’ve seen too often:

A practice needs help. A billing company with a beautiful website, expensive video production and high fees waltzes in…and makes things worse. How can someone be a self-proclaimed expert in their field, yet still mess things up so badly for their clients? A lot of flashy marketing unfortunately doesn’t mean that a practice will receive effective help and see improvement.

This doctor hired such a billing company, which then never checked on their denials. They sent claims out, posted payments and offered a lot of excuses. That kind of thing just makes me mad. That’s a biller making a large profit on a practice, doing only the easy part of the job in exchange for it. How can any self-respecting biller just ignore denials? How can you turn a blind eye to all those failed claims at the clearinghouse? Why aren’t you on the phone with insurance companies, insisting you get through to someone who can correctly answer your questions? You’ve got to be either 1) NOT LOOKING or 2) You must not actually understand your job as a billing professional, how to do the job, or how important doing it right is to the well-being of the clients you have promised to help. It gives a bad name to the rest of us who are working away diligently for our clients, finding and solving the problems that arise and keeping that A/R low.

So – in honor of the doctor I just spoke with who has been through the ringer on their billing, and many others like them, I am extending our free Consultation and Review service to you.

No strings, no pressure. I would love to help a few more practices sort out the areas that are going wrong so that they can zero in on fixing them. The consultation is simple. I ask a few questions and collect some reports. Then I review the information with my team and talk with you to let you know what I see. If you want our help at that point, we can discuss it to see if we are a good fit for you, and if not, I’ll wish you the best, and send you off with ideas on how to improve your situation.

If you’d like to get some insight as to what’s going on in your practice from an exterior perspective, please give us a call. Or email, contact us on LinkedIn, Facebook, or send a smoke signal. We’ll be watching for it.

Have a great week!

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!