Initiating the claims process as soon as possible will result in your claim being processed within 30 days, rather than pushing it to the 30 to 60 day category. If you are not currently billing out daily, you should start.
Many plans have applications the physician, nurse, practitioner, or physician assistant must fill out that include their license number and NPI. Since some workers’ compensation companies pay differently for therapists who are considered in-network versus out-of-network, you need to check to see if your adjustments are due to a physician not being on a particular contract. Blue Cross, Blue Shield, United Health Care and Medicare are just a few that require this certification.
Reducing the turnaround time for your claims should be a priority. Handle all documentation requests from your billing department as they come will give you results in a month or two. When your billing department requests additional documentation either to process an original claim or fulfill a denial or delay in payment from the insurance company, your stay should be getting back to them within 24 hours. Think about why your accounts receivable is in the 90+ day category. If you are billing on a monthly basis, your claims are already in the 30 to 60 day category. On top of that, you have to wait to hear back from the insurance company, soy your claims are now in the 45 to 60 day category. Now, add on any additional time your billing department has to wait for your documentation because your staff has been too busy processing patients, you’ve now entered the 75 to 90 day category. Hopefully you can see the importance of handling your documentation as they come.
Following up with your internal or or sourced billing department is critical. Some companies do not want to bother with secondary claims because the yield is low. Denials are also more work and commonly require more time with minimal results. Following up with them as frequently as possible – at least once a month – is a crucial step in lowering your accounts receivables.
Posted in Triumph Healthcare Finance