We know how many things can go wrong in the billing process. Here are some tips and tricks from the pros to minimize aggravation and maximize your revenue.
Problem: Timely filing errors
You’re probably aware that claims will be denied if they’re not submitted within the time allowed by the insurance company. Often too many days are lost when claims are initially submitted to the wrong insurance company, contain coding or other errors, or are not properly tracked to ensure they’re being processed in a timely manner.
Pro tip: You can re-file a denied claim using traditional paper claim forms submitted to the correct insurance company as long as you:
- Initially submitted the claim on time AND
- Received an Explanation of Benefits resulting from the incorrectly billed claim OR
- Received a rejection notification from an incorrectly coded claim
Be sure to include a copy of your proof of timely filing, keeping the originals yourself for future reference.
Problem: Coordination of benefits denials
It can be difficult to keep up with the many rules surrounding coordination of benefits (COB). If you choose to handle COB claims denials yourself, you’ll need to be proactive in researching the rules so that you can successfully appeal the denials.
Pro tip: Turn to these helpful resources:
- Centers for Medicare and Medicaid Services guide to “who pays first”
- Excellus Blue Cross/Blue Shield guide to coordination of benefits
Problem: Laboratory claim denials
Labs often bill for services rendered using incorrect diagnosis codes. Whether the error lies with your practice or not, some labs will refuse to recode the claim until you call to explain or verify the correct codes — and many will require that you also do so in writing.
Pro tip: Be proactive in helping patients resolve this issue by calling the lab to confirm the correct codes and following up in writing. Doing this supports patient retention and satisfaction