5 Ways to Improve Medical Claim Reimbursement

Often the handling of accounts receivable is considered distasteful, something that can be ignored or should be handled by somebody else.  Too often the calls don’t get made to insurance companies, the appeals don’t go out, or the resolution of denials is put off.  Even though it may be difficult to find time to perform these tasks, they are an integral part of every successful medical practice.

It is crucial to have a plan for working your accounts receivables.  Follow these suggetions below to get your cash flow going:                                            

  • Setting aside the time and assigning the accounts receivable task to one person is the most logical option.  This assures a focused attempt to resolve problems and may reveal erroneous patterns in billing that are missed by several people handling the receivables ‘on the fly’ or ‘when they have time’.
  • Most insurance companies have made information quickly available online through their secure websites.  Often an EOB or check that has been missed may be found online and entered in the accounting software without picking up the phone.  The website can also offer more detailed information regarding claim denials.  Additionally many insurance websites offer direct email to quickly access customer service with any questions.
  • Each insurance company has an appeal process that must be adhered to in order to get the attention directed to your claim. Keep an appeal file with details (also available on websites) so that the information is quickly available. When an appeal letter is written, keep a copy on the computer and use it to easily change only the patient information and date, thereby saving additional time and keeping the format needed by the insurance company.
  • If there is no other way around making the occasional phone call to an insurance company, they often have an IVR (Instant Voice Response) telephone number where you can retrieve all the information needed regarding claims and eligibility. To accomplish this task quickly, make sure all the details are at your fingertips prior to making the call. If you must speak to a ‘live’ person, get as much information as possible at the time of the call to avoid repeat calls.
  • Finally, if there is no time to squeeze these tasks into any staff schedules, check into hiring outside personnel that will concentrate on this important job. Make sure they have the communication skills and availability to give feedback when necessary so that recurrent findings or problems can easily transfer back to billers or medical staff. 

Staying involved with accounts receivables is a win-win solution for medical offices, patients and insurance companies. The best medical billing software can help your practice stay organized and maximize claim reimbursement.