Don't Let Insurance Companies Get You Down
One of the most commonly offered excuses by insurance carries for not paying a claim is “we need our special form to be completed by the insured.”
Insurance companies will place the burden on you, the provider, to encourage, coerce or other wise obtain the completed form, or else you can expect an indefinite delay or outright rejection of payment. It takes a periodic review of aged insurance receivables to spot chronic abusers of this ploy.
You may be the sole provider of services for a large industry in your community. Providers in this position often suffer delays and rejection in amounts that can severely impact insurance receivables balances. Insurance billers rarely have the time to do filing, regular insurance follow-up and make the necessary patient contacts that would cause the patient to comply with the carrier’s requests for the special form.
Usually to comply with the request, the patient must go the company’s human resource department or the office manager to obtain the special form. The form must then be completed and mailed to the insurance carrier. Sometimes getting the form to the proper department of the carrier can be difficult when there are several addresses that the carrier used. Claims routed to the wrong department can be lost or processing can be delayed. What can you do to avert this type of situation?
When you identify a carrier for which this is a problem, contact the employer’s business manager or human resources department and explain your dilemma. Ask them for a supply of this special form.
Next, inform your admission and registration clerks to be alert to patients who have coverage with this carrier. Make the completion of this form part of the normal admission and registration process so process so a properly completed form can be forwarded along with the claim.
The benefits to be gained are not just limited to improved recoveries. The delays in payment that occur when the form is not sent result in wasted man-hours and in distorted outstanding receivables balances on your aging reports.
The public relations gains from not having to contact the patient will help improve your image.
And then there is the benefit of the improved morale of the insurance billing staff for not having to same old battle, time after time.
Sometimes we have trouble seeing the forest because of all the trees. We have other suggestions on handling insurance receivables that may be helpful to you.
Please don’t hesitate to contact us with any comments or questions you have.
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