No Claim Left Behind

March 22nd, 2013 - Shannon Bosley

Categories: Accounts Receivable|Payments Billing Claims Collections Denials & Denial Management Insurance Practice Management

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Call me crazy, but it is always exciting to me when I assist a practice in getting reimbursed on unpaid or delinquent claims. Claims that were denied, viewed as uncollectable, past filing deadline, or a multitude of other reasons. I even have a little dance that I do! Why not? We need to get excited about our jobs, and in these times of decreasing health care reimbursement, it is crucial that we push forward and adopt a motto of "NO CLAIM LEFT BEHIND"! Here are a few tips to help you become persistent in your reimbursement efforts for your practice.

First and foremost, don't get behind. I know it seems elementary, but it is very important to have solid Billing Processes. Set goals and tasks that need to be met daily, weekly, and monthly, and mark them on your calendar to ensure you comply.

Resolve payment denials and other claim related requests as they come in. Don't let them stack up.

Communicate denial trends with your provider or other appropriate staff. There may be coding, office policy, or even staff issues that need to be addressed. Resolving the issue quickly can help avoid future denials and possible compliance risks.

Identify your delinquent claims on your Aging Report monthly. Most Practice Management Systems can easily compile this report. Go through each claim to follow up to see why the claims has not been paid.

Record detailed account notes on what you have done on each claim. Include dates, contact names, and other pertinent details. This proves vital when you need to access the account again and take further action on a claim.

Know and understand all of your top Payer guidelines for appeals, reconsiderations, and resubmission of corrected claims.

Develop a QRG (quick reference guide) for all of your payers that includes required information when working your claims.

Finally, take action on every one your delinquent claims and follow through to resolution. In most cases, persistence will lead to positive results.

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