Practice Management Alert

Take matters into your own hands when patients don't carry their weight

You don't need to write off balances for patients with state-run medical assistance - being proactive is the key to reimbursement on every claim.

Most state-run medical assistance programs rely on patients to turn in certain paperwork and bills to a caseworker or other program official before they are approved and eligible for assistance. And misunderstanding, language barriers or apathy can cause patients not  to comply with this responsibility - leading you to miss filing deadlines, get claims denials for ineligibility, or send accounts to collections (where they won't get paid because the patients have no money). Try one of these methods to take control of the situation:

-Send a copy of the bill and any necessary paperwork directly to the patient's caseworker, says Merrie Gaik, CPC, office coordinator at Charlotte Surgery Center in Port Charlotte, Fla. And stay on top of any new developments by keeping in close touch with the caseworker while you're waiting for a patient's eligibility approval.

-Scan your statements twice a month for self-pay and uninsured patients who may be eligible for medical assistance. Before sending out a patient statement, call your state's program or check online to see if the program recently approved the patient for medical assistance. Patients often complete their paperwork but fail to notify the practice, says Pat Suhr, RN, CPC, billing manager at Maternal Fetal Medicine of Central PA in Harrisburg. Calling or checking eligibility online will save you the hassle of having to bill your state's program later on and risk missing the filing deadline, she adds.

-When you have a medical-assistance patient scheduled, call your state program ahead of time to confirm the patient's eligibility. If the patient is still ineligible because he hasn't finished his paperwork, make sure someone in the billing office speaks with him about doing this immediately. If a patient knows your billing office is staying on top of the situation, he may feel more motivated to fulfill his end of the bargain, Suhr says.