Practice Management Alert

Let this proven sample policy guide your efforts Every office has them -- outstanding claims that plague your collection efforts. Implementing a standard follow-up policy, such as this one from David R. Grover, accounting director for Otolaryngology Associates in Fairfax, Va.., can help. "The policy takes the employee through how to work a claim, file documentation and put notes in the system," Grover explains. His employees "all know that they are not to deviate from this policy." Results: Will a claim follow-up policy really make a difference in your practice? For Otolaryngology Associates the policy made a big impact. "Since its implementation, our outstanding claims have dropped almost 50 percent," Grover says. Policy for Follow-Up of Claims and Patient Calls: Effective Jan. 2, 2007, a systematic process will be used to follow up on claims submitted to insurance for payment REPORT: Run the report from the practice management software's billing module and sort it in descending order, according to Visit-Insurance Balance. Work claims from highest to lowest dollar amounts. Please work claims, both insurance and patient balance, down to $50. The report should be run in descending six-month increments. Run the report for one insurance group at a time. STATUSING CLAIMS: Obtain the status of claims online whenever possible. Management is aware that we cannot status Medicare and most OneNet claims (from the third party) online. DOCUMENTATION: Fax claims requiring documentation whenever possible, and note the claim # clearly on all pages. CORRESPONDENCE NOTES: Notes in the system must contain the following information either in part or in full: claim #; check #; date paid/rejected; amount paid & patient responsibility; reason for rejection; and documentation submitted. Also include the name of the person you spoke to at the insurance company (if applicable). SCHEDULE: Monday, Tuesday, Wednesday: Work billing report, pull documentation, file claims. Thursday: Return patient calls. Friday: Work EOBs. This should not take all day as you will have statused most of these from the billing report. As your schedule permits focus should be on working the billing report. ADJUSTMENTS: Until further notice, submit all adjustments over $200 to Stacy or Dave for approval. Please see the attached sheet. PRODUCTIVITY: Each collector is required to work no fewer than 30 accounts a day. Failure to meet productivity goals on a consistent basis will result in disciplinary action up to and including loss of monthly incentives.