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Would like to share a few tidbits that could benefit not just you, but...

Melanie Posted Thu 01st of April, 2010 14:37:15 PM

... your billing department as well.

Often, this is something that is simple as a learning-curve, while others are repeat offenders that just dont understand the impact of how checking in a patient and what you ask that patient for various pieces of information - can affect the billing/collections flow of information.

A previous position held was for a Cardio-Thoracic Specialist in Jamaica Plain, MA - I was in charge of his entire medical billing, collections, appeals - you name it, I did it.

Often I would run into several key areas that were just not getting corrected or improved that in the end would cause problems with the billing.

So - If this helps someone out there checking patients or perhaps turns a light-bulb on for you, Im glad...

When a patient checks in for their appointment, consider asking the questions in 'this' manner:

"What is your current address/Telephone number?" Dont ask them if their address is still the same. You might be talking with a patient who has a large outstanding balance that if we try to send a bill to them, its gonna get returned for no-forwarding-address.

"What is your date of birth?" Even if they are the only patient with that name, it never hurts to check. Even more so when you have multiple patients with the same name.

"What is your insurance?/I will need a copy of your insurance card" Dont ask if they still have the same insurance - this can be a huge detriment to the billing department. You may have this sweet elder patient who has Medicare - but when their claim processes, it says they actually have a 'replacement' plan instead - you might have cost the office the benefit of a paid claim, if we cant get the correct insurance information from Medicare's IVR. Copy the cards you are given if they are different than what you have. If they are the same - compare the card with what you have on the account.

"Your copay is..." While this is an inter-office decision - it is a very good practice to collect all copays upon checking in for the appointment. By collecting all copays up front at the time they check in, you are helping to reduce any unnecessary billing costs to the office, and ultimately to the patient because then this would have been already collected.

If your patient gives you insurance cards and they just dont make sense to you - talk with your billing department rep - they can help you understand the ins and outs of insurance cards in general. There are often plans that you are suppose to bill ONLY, while others you cant bill. It will happen for sure!

Hope this helps....

SuperCoder Answered Mon 05th of April, 2010 06:10:27 AM

Thanks Melanie for sharing this valuable information, specially for the billing and the AR people.
:-)

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