Practice Management Alert

For offices that file only paper claims, creating a log system or suspension file may be the answer. Leskiw offers the following advice:

The Log System. When a claim is submitted, record the filing date, patient's name and chart number. Also include the payer's name and address and the amount billed. The actual claim can be temporarily filed in the patient's chart or in the unpaid insurance file. After the day's or week's claims have been recorded, leave a blank space to tag the claims submitted during that time. Consider using Post-its to flag the dates or highlighting them in a specific color so you will be reminded to review them in three to four weeks. As payments come in, pull the original claim form and compare it to the explanation of benefits (EOB). On your log sheet, record the amount paid with any difference. In the status/comment column, record any notes such as "claim sent to review" or "claim denied for additional information."  The Suspension File. Set up a series of files for one month at a time. Do not mix current claims with claims over 30 days. You may find it necessary to have a current file, a 30-day file and a 60+-day file.

A practical method for creating your system is to use three separate hanging files, each with four separate folders for week 1, week 2, etc. Mark the hanging files month 1, month 2 and month 3. Place the current month's claims in the hanging file marked month 1. Place the claims over a month old in the month 2 file, etc. As the weeks go by, roll the outstanding claims to the next file.

For easy access, keep files in alphabetic order. Make sure to review claims regularly. Those that have been filed in the current month generally require no extra work until the EOB is received. Claims over 30 days should be reviewed for possible payer inquiries. $ $ $