Your practice’s billing team likely spends a lot of time on the phone with insurance companies. In a perfect world, claims would go out and payment would come in, but it’s never that simple. If a medical claim isn’t paid within 60 days, your billing team will have to investigate why. In this article, we’re going to share some tips that our Collectors use to get accurate information from the insurance companies, quickly.
1. Call Early or Late
“Your call is very important to us, please wait for a representative to take your call. You are #56 in the queue.” Sound familiar? Waiting on hold takes hours away from your staff, time they could be working on other high-priority tasks. We recommend calling right when the insurance company opens or 30-45 minutes before they close. In our experience, the wait times are much shorter when calling at these times.
2. Gather All Information Before Calling
There is nothing worse than waiting on hold and having to hang up and call the claims department again because you didn’t have the information needed. We recommend gathering all information before calling. Your staff should make sure they have all the patient and provider information as well as any referral or authorization information. This will streamline the call and reduce wasted time.
PRO TIP: Record previous reference numbers and representative names in the patient’s record so all team members can see what has been done and follow up when necessary.
3. Use Insurance’s Provider Portal
Provider portals are designed to make managing your claims easier and save both the insurance company and your staff time. Tedious tasks like submitting corrected claims, uploading notes, and adding prescriptions can be done through the provider portal without the need to call the insurance company. Next time your staff calls the claims department, ask if they have a provider portal and what key functions it has to reduce the need to call the claims department directly.
4. Ask for Escalation
There are situations that warrant a request for escalation or to speak with a supervisor. For example, if your provider agreement says a claim should be paid in X days and it hasn’t, you can call and ask for an escalation. Another example is if the claim was reprocessed but payment still hasn’t been received after waiting the appropriate amount of time. If your staff knows that the information that the claims department rep is telling them isn’t true, they should absolutely ask for a supervisor instead of wasting time arguing with the representative.
5. Ask for Email or Fax
We often suggest calling the insurance company to get answers quickly, but a phone call isn’t always the fastest method to get answers. Your billing team should ask the claims department for any email or fax numbers that they can use to make their job easier. Whether that means an email to send corrected claims or a fax number to send proof of timely filing. Your staff should always be looking for ways to streamline their processes.
If the money in your accounts receivable is aging but your staff can’t tell you when payment is expected, you’re likely losing revenue. Want to know how much? Sign up for a billing assessment here.