Insurance reimbursement and collections are more complicated than ever. And, with COVID-19 and the hardships every practice has faced this past year, having systems in place to collect money up front and stop unnecessary waste is crucial.
Follow these six suggestions to improve the AR and overall financial health of your practice:
#1 CAPTURE ALL CHARGES
Don’t throw money out the window — make sure you’re capturing all charges! Most practice management systems have extensive reporting features, including a missing charge slip report. This report notifies you of any appointments without a charge posted. And don’t forget to run reports from testing equipment to ensure all tests have been captured and billed.
#2 CHARGE AND COLLECT FOR PATIENT-RESPONSIBLE SERVICES
Some services, like refractions and pre-cataract surgery testing, aren’t covered by insurance payers. Don’t miss out on revenue for these services by making sure your practice is collecting payment for them.
#3 COLLECT COPAYS AND BALANCES WHEN THE PATIENT IS IN THE OFFICE
One of the easiest ways to stop revenue loss is to collect patient balances while the patient is in the office.
Many patient insurance plans have high deductibles and out of pocket costs, in which the insurance processes the claim without payment. For patients having surgery, this is especially important; the patient may be responsible for the entire allowed amount. Collecting this money from the patient up front keeps your AR healthy and saves the practice time and money. Stamps, envelopes, and statement costs can add up quickly.
A best practice is to collect at the time of service. Train your staff to identify patient balances, communicate clearly to the patient how much they owe and why, and make it easy for the patient to pay.
#4 SCHEDULE EFFICIENTLY AND MANAGE THE WAITLIST
A canceled appointment is lost revenue and wasted time for the practice. Does your practice keep a waitlist of available patients who can fill canceled appointment slots? This is an easy and efficient way to stop revenue loss.
Recognize that COVID-19 has presented operational and financial challenges that ophthalmology practices have never faced before. Practices must maximize every opportunity to be financially healthy.
#5 CHECK INSURANCE ELIGIBILITY BEFORE THE APPOINTMENT
The key to a successful insurance eligibility process is to check benefits prior to a patient’s visit. This gives your practice time to resolve any issues before the patient arrives. Seeing a patient without current insurance benefits can lead to lost revenue for your practice!
#6 MAKE AUTHORIZATIONS EFFICIENT
Does your practice see patients who require authorizations or referrals? It’s vitally important that your practice has a streamlined, efficient process for obtaining authorizations. No authorization means no money!
Highlight authorized services on the charge slip so the physician and technician know what can be done during the appointment.
If services not authorized are performed, request a retro authorization immediately. Some insurance carriers don’t issue retro authorizations, so make sure your practice is familiar with the rules of each plan.