Often, when I am reviewing a client’s medical receivable, I notice revenue lost simply because steps were not taken on the front-end that are necessary to secure payment and maximize collections. In some cases, if a few initial steps are not taken on the front-end, there is nothing a biller can do to get a claim paid…the ship has sailed. Fortunately, these mistakes can be avoided by following a few simple steps:
- Make sure to collect a patient’s copay prior to their visit–this may seem obvious or perhaps “no big deal”, however, some insurer’s payment is the copay alone and no further reimbursement will be made. Failure to secure this cash upfront could mean that you will not see another dime for this visit.
- Check to make sure a patient is truly eligible with their insurer. Some patients may not even be aware that their coverage has been canceled, others may try to be seen without insurance. It is too late to collect payment once the patient is out of the office.
- Check to see if an authorization is necessary for this patient’s visit. Insurers are routinely making policy changes that you may not have realized; all it takes is a quick phone call to be certain.
- Get a copy of the patient’s insurance card, front and back. This is your insurance to make sure there weren’t any keystroke errors during intake, or, to be certain that there isn’t a different phone number for a patient’s particular policy.
- Check prior visits to be certain there are no outstanding balances due. Perhaps the patient owes coinsurance or a deductible has been applied to your visit. A patient is more likely to pay their bill when they are standing in front of you, as opposed to when they receive a bill in the mail.
You might think that these steps are all obvious, however, I assure you they are not. Furthermore, one may not realize these are necessary steps, unless you are familiar with the billing process. Your front-end staff is not only there as a smiling face to greet patients, they should also be looked upon as a conduit between the patient and the biller. If steps taken during intake are done haphazardly, your bottomline will be affected. Share these with all members of your staff, so that you can feel confident that you are maximizing your collections.
It’s also important for you to keep an eye on unpaid claims and make sure that your medical billing is as profitable as it should be. If you’re not sure where to start, I suggest using the MAS Profitability Calculator to make sure your office isn’t losing money. Just sign up for the your complimentary copy of the MAS Profitability Calculator from the home page of the MAS site now*.
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