2 Claim Filing Mistakes Your Biller Should Ditch

Posted by Janelle Pauli on Thu, Feb 25, 2016 @ 10:02 AM

Claims management is an important department in any eyecare practice. And, it's crucial for you to fine tune your claim filing processes in order to make sure that you're getting your full reimbursement on all patient visits. It's easy for your billing workflow to get over complicated and neglected. But if you provide your biller with the right tools and resources you'll be one step closer to a more efficient workflow. Let's look at two common claim filing mistakes you should put an end to, and the new processes you should put in place. 

Put an End to these Two Disruptive Claim Filing Mistakes

Stop: Verifying Eligibility on the Phoneclaim filing mistakes

Calling payers to check on eligibility can cost you 10-20 minutes per patient. A good workflow should allow your practice to see about 30 patients a day, and that would mean spending around 5 hours a day just checking patient eligibility. Checking eligibility online is much faster than spending time on the phone, but a lot of practices are intimidated by online verification. With the right training, checkling eligiblity online can usually provide more details than what you can get over the phone. 

Start: Using an Automated Eligibility System

The most efficient way to check eligibility is to use the automated real-time eligibility systems provided by clearinghouses and practice management systems. They allow you to quickly check on patients across multiple payers with complete benefit profiles, all in one place. This will make it easier on your staff to get walk in patients the right coverage on the spot, and your scheduled patients will have an idea of what their invoice might look like before they come in for their appointment.

Stop: Ignoring Reports

Is your biller regularly reading reports and following up on claims? A lot of practices will say that they only do this when they notice a claim hasn't been paid. But really, by the time you realize a claim hasn't been paid you might find that the same problem has been happening to other claims because of a common coding error. Or, it could mean that there are other similiar claims that aren't being fully reimbursed. With regular reporting these are the types of problems your practice can avoid.

Start: Using Reports to Boost Your Revenue

Depending on how you're managing your claims, reports are usually provided by your clearinghouse, practice management system, or outsourced provider. Find a solution that provides you with detailed reporting so you can stay on top of your claims every step of the way.

Make a regular schedule for reviewing your reports, and get in the habit of sticking to it. A few reports you should be focusing on are your accepted claims report, aging reports, ERA reports, and account receivables. Staying on top of your reports should give you greater insight into how well your practice is performing. 

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Tags: Practice Management, Practice Efficiency, Electronic Claim Filing