Account Matters Blog:

Data Entry and Clean Claims

Posted by Stacey Fitzsimmons on July 18, 2018

As a billing company we estimate that at least 80% of the denials we see can be traced back to data entry/accuracy errors.  These errors occur on all types of insurance claims. 

Here are some examples:

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Topics: Billing, Front Desk

5 Rules for Getting Paid

Posted by Diane McCutcheon on July 18, 2018

The process of taking a new patient, providing services and getting paid sounds so simple.  I mean, why shouldn’t it be?  Why is such a simple concept so complex? It all comes down to understanding the rules and regulations of each insurance carrier, knowing how to comply and implementing operational systems that will support your ultimate goal - getting paid from insurance and patients.   

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Topics: Billing, Front Desk

3 Reasons Why Billing Staff Relies On Accurate Information from the Front Desk

Posted by Diane McCutcheon on July 18, 2018

The front desk is a biller’s biggest asset when it comes to getting paid for all the hard work you put in with your patients. Understanding this relationship and how these two roles work with one another is crucial for a successful practice.  

There are many things a front desk must do before the patient’s information gets to the biller. This includes providing benefit checks, entering patient demographics and managing referrals and authorizations. If any of these essential functions are not done accurately and timely, major problems will arise when it comes time for the biller to submit claims and get paid right the first time.

Benefit Checks

The front desk must check each patient’s insurance benefits before their first visit.  We also HIGHLY recommend that your front desk encourage the patient to check their benefits as well.  This helps to avoid getting conflicting information. If there is an issue, it can be addressed immediately.

There are many easy ways to get this job done fast and correctly.  In most cases you can go through the insurance portal or clearing house but there will be times when you just have to pick up the phone and call.

We have seen many denials that could have been avoided if a benefit check had been done.  For example, some of these denials might include patient’s insurance was terminated, the therapist is not in network with patients carrier and the patient has no out of network benefits.   If treatment begins before these issues are addressed, there is a good chance that the biller will not be able to send a successful claim and get payment for that visit. 

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Topics: Billing, Front Desk

Billing Challenges- Why is it so Hard Getting Paid?

Posted by Diane McCutcheon on July 18, 2018

As a consultant I am called in to practices to evaluate the billing function and to answer questions like why are we getting so many denials, why aren’t our payments consistent, how do we know we are charging correctly, are we in compliance and most of all where is my money?  And this is on the heels of investing in and implementing a new billing system. 

We have all read articles on choosing the right system and they all promise that you will get better payments, stay in compliance, and your ability to charge and document will be enhanced, but the truth is, in order to get paid and get paid right the first time you need a competent, well trained staff and processes in place to support your goal – payment for services rendered. 

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Topics: Billing, Front Desk

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