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3 Expert Tips on Claims Management

Posted by Janelle Pauli on Aug 24, 2015 10:00:00 AM
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Claims management. It can be one of the toughest tasks to have control over in your eyecare practice, but it doesn't have to be. With the help of a claims management solution, along with diligent processes, you can be on your way to having a good grip on your claims and reimbursements. We recently released an eBook titled, 8 Claim Filing Habits to Say Goodbye to in 2015. We've pulled 3 expert tips that our own insurance claims manager shared with the eBook readers to discuss with you today.

3 Claims Management Tips You Didn't Know You Needed

1. Train your staff to interpret insurance jargon by calling payers first, and then checking for eligibility for the same patient online. From there, you can match the online records to the information that you received from the phone.

Old habits are hard to break, so if you're in the habit of always calling payers to check eligibility this is a good way to start the transition to checking eligibility online. Some claims management solutions allow for eligibility checks to be done in real-time, online. That way you can get eligibility and authorizations from multiple payers with complete benefit profiles all from one place.

claims management tips2. Even if your practice is fully prepared and trained for the switch to ICD-10, it's still important to be prepared for payment delays when the change hits. Payment delays can happen for a variety of reasons, including coding mistakes or a mess up on the payer's part. To be well prepared, set aside 3-4 weeks of operating capital so that your practice can resume daily operations if payments are delayed.

ICD-10 is right around the corner. Only 5 weeks left to get your practice up to speed and ready for the switch. While this doesn't give you much time to bank some of your operating capital, you do still have time to get your practice ready for a smooth switch. Medicare states that a knowledgeable biller needs approximately 16 hours of ICD-10 study to be prepared, so you've still got plenty of time!

3. Practices should attempt to bill the patient three times before writing off a bill. Leaving an Advance Beneficiary Notice (ABN) of non-coverage as part of the front desk paperwork will ensure that patients know they are responsible for any remaining charges. You also want to collect full payment when the patients are still in your practice. Once they leave, your chances of collecting payment drastically descreases.

But, if some patients do walk out of your office without making full payment, paying attention to your reporting can help you keep track of balances that are still outstanding. A few reports that are important for keeping track of outstanding claims are your accepted claims report, ERA report, aging report, and accounts receivable.

Want more tips on claims management? Download a copy of the full eBook!

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Topics: Tips for ECPs, ICD-10, Biller

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