Revenue Cycle Insider

Question: We are trying to outline our query process and want some more insight. When you query a provider and they do not respond to the query, how many attempts should you give the provider to respond before you give up on billing for the service in question?

Minnesota Subscriber

Answer: The number of times you query a provider before choosing not to bill for a particular service can differ depending on many circumstances, but it’s generally accepted to try at least a few times. It’s also crucial to keep a record of all communication attempts for future reference, or   in the event of an audit.

Also, try various forms of communication, not just email (for example). If you are finding it hard to reach the practitioner via email, try calling them — or even dropping by their office if that’s something you are able to do — before you let the service go unpaid.

Here are some tips to improve your query process:

• Use clear and direct language, but remain respectful when you attempt to get the information you need.
• List the patient’s identifying information like their name and date of service; also, include any necessary supporting documentation.
• Do not lead the provider with your language in the query.
• Ask about any additional procedures, testing, or images that could help with the claim.

Creating a template for your entire office to use might be helpful to keep everyone’s queries consistent in the future.

Lindsey Bush, BA, MA, CPC, Production Editor, AAPC