| Now that most practices are using some sort of | | | | reconcile those back into the practice management |
| electronic claims submission solution, there are lot's of | | | | system. |
| snafus or lessons learned that you may want to | | | | The above problem can easily be solved by using a |
| know to improve the process. By the way, if you | | | | practice management solution that allows electronic |
| aren't submitting your claims electronically yet, you | | | | claims submission and reconciliation as well. This not |
| better get to it. You are losing money and time for | | | | only reduces redundant work, but speeds up |
| no reason at all. It doesn't matter what type of | | | | payment and practice efficiency by allowing time to |
| practice you are in. | | | | spent on aged accounts and collections. |
| Most electronic claims submissions are either done, | | | | Another inefficient method that some practices use |
| using software pushing claims through a clearing | | | | is, hiring non-professionals to do their billing work. |
| house or directly to an insurance company. If you are | | | | There many issues with this, but I'll try to touch on a |
| accepting more than one or two insurance | | | | few to give you an idea of how inefficient it is. Most |
| companies, you should be using a clearinghouse. They | | | | of the time employees who are paid hourly, are not |
| can submit claims to all the insurance companies and | | | | motivated in any way to get the practice paid on |
| allow you to only have to use one interface for | | | | anything that is going to be hard work to get. For |
| submitting claims. | | | | example: Sometimes it takes multiple phone calls and |
| One of the inefficient methods doctors or practice | | | | a couple appeals forms just to get claims paid. It |
| management personnel will use is to have one | | | | doesn't matter if the claim is worth $25 or $5,000, if |
| system for handling patient data like scheduling and | | | | it is hard, complicated or laboring, most likely a low |
| patient charts etc.. Then when it comes to submitting | | | | paid hourly employee isn't motivated to help get the |
| claims, have to re-enter patient information into | | | | practice paid. At least not consistently. This is why i |
| another application or web interface to submit a | | | | suggest that every practice should look into bringing |
| claim. This is highly inefficient on many levels. Think | | | | in professionals to do the billing. Whether it is bringing |
| about the duplicate work going into re-entering | | | | an experienced veteran that has proved to get aged |
| patient information alone. Another issue is the | | | | accounts paid or partnering with a medical billing |
| reconciliation of payments from payers (insurance | | | | company. Either of these 2 options is going to |
| companies) to the doctor for specific patients. You | | | | guarantee better cash flow and reimbursement rates. |
| have to receive checks and EOBs, then manually | | | | |