The world of electronic claim management is an ever-changing labyrinth of rules, standards, and charges. Needless to say, when it comes to managing this important aspect of your business, things can get a little dizzying. With different providers wanting different information for the same procedures and innately complex and detailed billing, it's important to have a game plan for managing electronic claim filing.
It is often said "you can't manage what you don't measure", but by making a practical assessment of common challenges in optical claims management, your practice can begin to better stake the claims as they come. With our vast payer and provider networks, VisionWeb is aware of claim management problems and has highlighted a list of common issues.
Do any of these sound familiar to you and your practice?
How Your Eyecare Practice Can Take Control With Electronic Claim Management
Rejections, not such a dirty word
If your claims are rejecting, it may not be a bad thing. Often times, cross-training may tackle a simple coding problem or a commonly missed feature in your PM system may be the cause of a great loss of money. Review your most common rejections to learn where subtle changes can be eliminated and increase your reimbursement rate.
The Paper Game
Submitting claims on paper requires more manual effort and increases human error. Eliminate these problems and get paid faster. And with the postal service's regular service in question, where is your consistent method of communication with payers? Online.
Hiring the Right Biller
Too often we look to cut corners by hiring staff at a lower wage. When considering a new biller for your business, consider how much you want to be paid. By hiring a biller with experience, they can increase your income by bringing in more money each month, coding properly, and understanding the ins-outs of insurance companies. Some practices provide the biller an incentive for achieving certain levels of reimbursement. Let's all make some money!
By being aware of these common pitfalls, your practice can identify tactics that will make electronic claim management as effective as possible. So remember to submit the cleanest claim possible, automate processes where applicable, use a solution that incorporates claims tracking and reporting, and have the right people on staff to get the most out of your claims.
Are you interested in learning more about VisionWeb's Revenue Cycle Management services? Click the link to set up a consultation with our product experts.
Editors Note: This blog was originally published in October 2011 and updated in September 2022.