Optometry Coding & Billing Alert

Published on Wed Apr 07, 2004 PDF

Question: We had a run-in with one of our carriers, and ever since then they have been really slow to respond to our requests. What should we do?

New York Subscriber

Answer: Turns out Mom and Dad were right after all: You will get what you want if you just use your manners.

Industry experts agree that yelling and a bad attitude will do little to help your case when dealing with insurance companies.

Make every attempt to resolve all issues in a friendly yet professional manner. Unfair as it may seem, insurance reps are likely to disregard your call and your requests if you are nasty and negative on the phone. But if you know your business, then you probably know more about how the carrier should pay the claim than the person at the insurance company. So bite your tongue and consider it your privilege to educate that person.

If you know you are right, don't be afraid to stand your ground. If all else fails, however, ask to speak to that person's supervisor. New claims processors at insurance companies often don't understand the difference between medical claims and routine vision claims, so you may have to calmly educate them.

Payers have been known to drag their feet in response to a feisty billing office. And this only makes your job harder both now and in the future, not to mention slowing payments. So, the next time you feel like screaming, think long-term, then grit your teeth and be pleasant. Get your point across -- just do it tactfully.

-- Reader Questions and You Be the Expert answered by David Gibson, OD, FAAO, practicing optometrist in Lubbock, Texas; Janelle Lemire, office manager for Peter Pegolo, OD, in West Hartford, Conn.; Joan Elfeld, CPC, president of Denver-based Medical Practice Support Services Inc.; Robert Wanerman with Reed Smith in Washington, D.C.; Margret Amatayakul of Schaumburg, Ill.'s MAConsulting; and Boston Bar Association president Rene Landers.