Previsit Information Can Reduce Payment Problems
The best time to address potential collection
issues may be before a patient’s visit—when
your staff can obtain and verify information, identify problems and head off
potential difficulties.
Your office previsit procedures can positively influence collections. One
objective is to confirm the payment flow before each scheduled patient
encounter. A second is to have patients arrive on time, well aware of what
is needed to satisfy their financial obligations. And all of this begins
with up-to-date coverage information.
Payer Confirmation
You can easily learn and/or confirm your patients’ insurance information
by making it part of your appointment reminder routine. Perhaps your staff
already call patients a day or two before their appointment to confirm the
date and time. The same call might be used to check payer information and
make the patient aware of his or her financial responsibility. And, for any
patients who have a high outstanding balance, the call can serve as an
occasion to schedule a preappointment meeting with your practice’s financial
manager.
Coverage Eligibility
Knowing the patient’s current insurer information lets your staff verify
coverage eligibility with the appropriate payer before the appointment—thereby
reducing coverage-related claim denials. The eligibility check may also
uncover requirements that, if missed, could lead to other collection
complications, such as authorization or referral requirements or frequency
limitations. Checking eligibility may even reveal existing coverage with a
second payer. Failure to identify the second payer and adjust your claims
accordingly can often result in a “bill another carrier” denial.
Follow Up
Any required referral or preauthorization must be in hand before the
patient’s visit. So, it is essential to make tracking and following up on
such documents part of your standard office procedure.
Health Care Commentaries is
provided by Somerset’s
Health Care Team
for our clients and other interested persons upon request. Since
technical information is presented in generalized fashion, no final
conclusion on these topics should be made without further review. For
additional information on the issues discussed, please contact a member
of our Health Care Team. This
document is not intended or written to be used, and cannot be used, for
the purpose of avoiding tax penalties that may be imposed on the
taxpayer.
Somerset CPAs,
P.C.
3925 River Crossing Parkway, Third Floor
Indianapolis, Indiana 46240
317.472.2200 • 800.469.7206 • FAX 317.208.1200
http://healthcare.somersetcpas.com
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