Non-Negotiables for Getting Your Claims Paid

• Data Entry (accurate & complete info) is the first step. 

• Eligibility and Benefits - verify insurance BEFORE any services are rendered.

• Collect all necessary information and documents at time of service, complete paperwork, copy of ID for responsible party and insurance card, signed consents, ABN if applicable.

These first steps are the responsibility of the front desk. Front desk should double check to make sure all demographics and insurance info is entered correctly. This is a very important position as many times they are the face of your business. Make sure to treat them as such.

• When the visit is complete, the provider must make sure the chart is documented to accurately reflect the treatments provided (all of them)  so the encounter can be coded correctly and then filed to the insurance.

• Payment should be collected from patient at time of service when applicable.

• Claims should be filed electronically through the clearinghouse within 3 business days of the date of service.

• Clearinghouse rejections must be worked in conjunction with insurance denials.

• ERAs/EOBs (paper) posted and non-payments worked accordingly.

• File appeals and claim reconsiderations.

• Send patient statements monthly for any outstanding balances (soft collections).

• Review monthly collections, AR reports and KPI's provided to clinic.

If you see areas above that you know have fallen behind in or just don't have the staff to handle.  We can take on these tasks (some or all) for you and/or train your staff to become proficient in them.  We truly tailor our services to what you need and want.  Let us evaluate what this looks like for you with no obligations. Check us out here for a complimentary consult.