“Uncorrected unpaid line items make up more than 17% of O & P annual loses”
Posting must address both the paid and unpaid parts of a claim. Unfortunately it is the most underutilized sector of in house Orthotic and Prosthetic billing departments.
Its sole responsibility is not, give an EOB a cursory exam, post it, and get it out of receivables. Experience and knowledge of O & P claims is required to efficiently post claims that get paid.
“Posting is the department that must identify loses”
The posting department must be able to identify and route any issues to other specialized departments. We have put together the departments, and networked them together to do just that. You need to call and discuss what we do and how it is done. It can really pay off, but it is more than just signing a contract.
Insurers purposely do not fully pay all they owe, “It’s an insurance money maker”!
Insurers use Line denials. They are small, written off, ignored, and neglected. They demand, calls, research, specialized web access and vary by insurance. Over time they really add up and reduce your bottom line income.
Patient deductibles: Private Insurers policy mixes now easily surpasses the 20% deductible of Medicare.
Insurances use deductibles to lower premiums and attract customers. Their policy holders normally do not have secondary insurances to follow up with.
In the past O & P claims were considered a budget breaking big ticket item with a high screen. Deductibles were nonexistent or insignificant and written off. This is no longer true.
Insurances Using the Medicare screen as a guideline have been constantly reducing their payments. O % P can no longer afford to treat them as hardship looses. To combat what is often ingrained we emphasis interoffice co-operation and have developed a posting system that lets you take maximum advantage of patient prepayments, installment plans, statements, call lists and more.
“Don’t let Take Backs fool you, they are not always Legit”
Take backs are often taken in small amounts per check (so as not to interrupt cash flow but actually fall under the radar). These take backs are often hidden by O & P Software and become missed uncorrected items that cost you money.
To quote one surprised facility, “We have become a non-profit organization”