How to Take Control of Your Claim Management

Posted by Jeff Rezabek on Thu, Nov 17, 2016 @ 14:11 PM

Managing the income you successfully collect from your insurance claims can be a challenging process with multiple bends along the lifecycle. These bends have the potential to stall progress enough to create a backlog of claims that won’t get worked - resulting in lost revenue. This post provides a few tips to help your optical practice take control of your claim management processes, and increase the revenue you collect from reimbursements.

The Keys to Mastering Claim Management Success

Send Electronic Claims

Use these tips to take control of your claim management

Believe it or not, there are still optical practices that are managing their claims the old fashioned way. While styles and fads of generations’ past have a way of resurfacing, managing insurance claims through paper practices is a habit that needs to be put to rest once and for all. Managing paper claims is incredibly inefficient and error prone. When you send electronic claims, you reduce repetitive manual work, decease overhead, and increase your management capabilities.

Better yet, send your electronic claims through a clearinghouse solution so you’re not hopping around from payer site to payer site. With a clearinghouse solution, you have access to thousands of payers to send electronic claims from one location.

Know Your Timely Filing Guidelines

Each insurance payer has their own time requirements for when a claim has to be submitted. With many clearinghouse providers, if you submit the claim to the payer after the deadline has passed, your claim will get denied. Because these deadlines are so important to your practice’s ability to effectively collect reimbursements. It’s essential that you know what the deadlines are for each payer and communicate those time requirements with your biller so they know what claims they need to work on first.

One way to help them stay focused on claims with the shortest amount of filing deadlines is to prioritize their workload with work groups that will help them focus on what needs to be done.

Review Your Reports

If you’re not recording your claim management metrics, then there’s a chance that you have no idea where your money is going, what’s causing your claims to be denied, and why it’s taking so much longer for your claims to get approved compared to your peers. When you track and measure your claim performance, you get insight into enhancing your claim management practices from the front of the office all the way to the biller so that errors are reduced, claims are cleaner, and AR days are shorter.

With these reports, you can gain a better understanding of why your claims are being denied and can use the data to improve processes to avoid similar errors in the future.

Do you know the reason why your claims are being denied? Download this ebook to discover the most common reasons for claim filing denials and how to fix them.

Get Your Guide to Common Claim Filing Denials

Tags: Tips & Tools, Electronic Claim Filing

Looking for tips to grow your eyecare practice business? Read on!