Partnering With You for Success!
By: Cheryl Sands
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| Cheryl Sands, Executive Vice President |
"Up front", Copay and Deductible collection are more important than ever now. We are seeing more and more plans in place with higher deductibles and copay requirements. Due to these factors, it is very important to be diligent to check patients' insurance benefits prior to seeing them.
Waiting for an insurance company to process a claim when the entire allowable (or a large portion thereof) has been applied to their deductible puts negative financial burden on your practice. It may take patients over 90 days and beyond to pay their bills in full. You can be proactive by asking your staff to collect copays at the time of service (this is a must) and to call for precerts, authorizations, while checking on the patients' deductible amounts that remain unmet. You have every right to collect the deductible amount upfront. A refund can always be issued later if the anticipated amount you collected was too much.
Some insurance companies require a pre-authorization or referral. Make sure your staff knows the rules/requirements for each individual plan. They must be diligent in getting these referrals/authorizations or your work may be for naught. We know how incredibly hard you work and we intend for you to get your full reimbursement.
Another way to help us is to make sure we get every piece of information up front that we need to transmit the claim. Here are items that are routinely left off the information that we get:
· No DX or cpt code listed
· Not referencing RT or LT when needed
· Leaving off a toe digit (11750-example)
· No insurance given
· No patient demo page - we need all information to include Date of birth, address etc.
· Nursing home face sheets omitted
· Failure to list the Date last seen and primary care physician when necessary
All of these items slow down your reimbursements. I have laid out things we need from you, now we need to hear from you! What can we be doing better to serve you? After all, you are our top priority and we want to exceed your expectations. We are here to help, assist and to listen and take action on every concern you may have. We look forward to hearing from you. Send us your thoughts at suggestions@smbmedicalbilling.com.
