By taking the time and effort to make some small tweaks in workflow, your practice can see big returns in the form of fewer denials and delays and increased collections.
1. When a patient calls to make an appointment, gather necessary information and remind them of payment expected at time of service:
a. Verify the address, phone number and date of birth of returning patients, and gather all demographic information from new patients
b. Ask if the patient plans to use medical insurance. If so, obtain all insurance information.
c. If any paperwork needs to be completed or updated prior to the appointment, ask the patient whether they would like to arrive early to fill out the paperwork or if they would prefer to be emailed or faxed the paperwork in advance. If your practice has a Patient Portal, paperwork can be placed in the portal for patients to download and complete before the appointment.
d. Remind the patient of the co-pay due at time of service and also remind them of any previous balances owed. If possible, collect on previous balances via credit card while on the phone with the patient.
2. Verify eligibility and benefits at least two days prior to the appointment. Automate this process through your EHR and practice management system to maximize savings. Most practice management systems have the capability to notify users if there have been changes to a patient's insurance, such as termination of coverage or change in co-pay.
3. When the patient presents in the clinic, instruct front-desk staff to review the pre-verified benefits with the patient to avoid confusion and frustration later. Taking the time to communicate what will and will not be covered will help patients understand bills they may receive from your practice. This can help your practice avoid situations in which patients are upset or refuse to pay their bills because they were not warned that they would owe anything.
4. Check to make sure the codes submitted on a claim are payable by the patient's insurance company. Some insurance companies do not pay particular codes, so it is a good idea to identify those codes and stop submitting them to those insurance companies. Finding a similar yet accurate code to use as an alternative will help you reduce denials and get paid faster.