The claims management process is long and complicated. And unfortunately, full of it's obstacles that can bring an electronic claim to a complete stop without getting paid. To optimize your claims management process and accelerate the lifecycle from submission to reconciliation, your optometric practice needs the right tools.
This post offers five tips to accelerate the claims lifecycle to help you get your claims paid faster.
5 Ways To Get Your Electronic Claims Paid Faster
Use A Claim Scrubber
Most billers know that they when they receive a claim, they can’t just send it off to the payer expecting to get the reimbursement immediately. Errors and discrepancies in the claim will result in a rejection which will stall the lifecycle until the issue is resolved or the timely filing deadline expires.
To accelerate the claims lifecycle, your practice should use a clearinghouse solution that includes advanced claim scrubbing functions that reduce denials by catching issues with the claims the moment the claim is submitted.
Stay On top of Rejections
Getting a claim rejection is frustrating, but it’s common. It’s what you do with the rejection that matters most. Typically, most billers are so busy submitting claims that rejected claims go unresolved and eventually turn into denials.
Using a feature to prioritize you claims by status will help you stay on top of your claims. If you configured your workgroup to prioritize rejections, then when your billing team receives a rejected claim, your team will be notified to work that claim first so they can address the claim rejection and resubmit it before the timely filing deadline expires.
Having the ability to look at claims management reports to decipher what your practice is doing right and identifying what adjustments you need to make is vital to running a successful practice. Unfortunately, the claims management reports that practices need aren’t easy to generate, and often times billers don’t know have the information they need to see how the practice’s billing efforts compare to the peers in the state and nation.
One report that your practice should monitor is the claim acceptance duration. With this report, you can see how long it takes a payer to accept a claim. Being able to look at your state and national claim acceptance duration and compare that to how long it takes your practice could give you the information that you need to make changes to accelerate your claims management.
If it’s taking longer for a payer to accept a claim from your practice than it is for your peers, then it could be a sign that a lot of your claims are being submitted with missing information.
Get Help From A Revenue Cycle Management Service
Effectively managing claims can be a headache. Submitting claims, working rejections, addressing denials, and tracking metrics can take up a lot of time, and if your busy practice only has one biller managing these components, then there’s a chance that burnout will quickly set it.
Enlisting the help of an optometry-focused revenue cycle management service will provide your practice with a team of billing experts who can successfully submit vision and medical insurance claims faster than the national average, work rejections, decrease bad debt write-offs, and provide transparency throughout the entire process with detailed performance reports, so you always know your claims management performance.
Discover how you can earn more money from your insurance claims by downloading your copy of “The Definitive Guide to Making More Money on Claim Reimbursements.”