Maximum claim return begins with Claim Preparation
“We have found normal orthotic and prosthetic billing departments loose 10% or more of their claims due to incorrect line item entries!”
Claim preparation must lay the ground work for the entire payment process. It requires time and background material to handle the differing privacy and policy approaches developed by insurance companies. If claims preparation is not done correctly and methodically your chances of collecting all the line items on your claim are greatly reduced. Critical extra information like “Priors” and “Modifiers” must be recorded properly and is often your last line of defense in collecting all the line items on your claim. If you miss just one prior you can loose the entire income from the line item. Miss a modifier and your cash flow from that claims slows way down.
“A dedicated department specializing solely in claim entry is a luxury in house orthotic and prosthetic practices can’t afford”
The first and most often neglected step in claim preparation, is being sure that the insurers have acknowledged receipt of your claim. If the insurer does not acknowledge receipt of claim it must be taken care of immediately, not in a week or two. Correctly recording critical extra information for a claim is also crucial. An improper preparation in a claim line item will jeopardize the income from that line and slow down the payment process.
“Careful claim preparation, done “line-by-line” is often your first line of defense”
A call, to the right insurer contact, to update a line item means money in your pocket. We do this at the same time we are processing the claim to ensure that it is correct the first time. Insurance companies often change their clearing house methodology, thus slowing processing and payment for improperly recorded claims. Further they don’t actually notify you, they only post a pair of numbers on a clearing house report. We watch for these occurrences and correct our posting accordingly. Secondary insurances often require a different format, if left uncorrected, cash flow and income will be lost.
We not only process your claim correctly the first time, we follow up on it to make sure it is received and cleared. We often have to reprocess many secondary insurances before they go through. By us keeping on top of each and every claim guarantees you will have steady cash flow from your claims. Our claims preparation department is all about keeping your cash flowing and uninterrupted.
Because we handle multiple companies, we are able to economically maintain the groups you need to successfully bill in today’s environment. One of the reasons we can do this is because we have uninterrupted time and skilled staff that handle this every day. Our claims department staff is solely dedicated to this purpose and does it very well. Orthotic and Prosthetic practices can’t afford to have this luxury on their own.