More Q&A
To keep up, you need the right answers. To get ahead you need the right
questions.
- John Browning & Spencer Reiss
These days, many providers’ Business Offices are having difficulty keeping up. They’re looking for answers.
Some are even asking questions.
Q. How long should an account be held before considering it for charge-off?
The answer depends on how you’re working your accounts. If there is consistent patient contact and follow-up, a provider can probably hold an account up to nine months from date of service. If you’re only sending statements with little or no other contact, smaller balances should be written off as early as 60 days from DOS. Larger balances should be written off after insurance has been resolved and the patient has had at least 60 days to respond. The key is if the account is being actively worked.
Q. What constitutes a “small” balance"?
A small balance (for bad debt write-off) used to be $25 and under. That’s no longer realistic. Accounts with balances of $50 to $250 fit the “small balance” category for bad debt write-off.
Q. What is the very minimum work that should be done by the provider on non-small balance accounts before bad debt write-off?
Accounts with balances over (some providers now use $500 as the break-point) should have at least one telephone contact. Balances above a certain point (say over $1000) should have multiple telephone contacts and special correspondence.
Q. Are there any “tricks of the trade” that can help get debtor’s attention prior to bad debt charge-off?
The most effective thing a provider can do prior to writing an account off is to fully inform the patient of what will happen if the patient does not quickly respond. This means giving the patient a hard and fast deadline and describing what will happen to the account next. Some providers also offer to work with the patient on just about any basis if the patient will contact the provider. The key here is to make sure the patient understands what’s going to happen. If the patient ignores the provider, the provider must follow through with the next step.
Q. Whose responsibility is it to pre-certify that an inpatient admission is acceptable to the insurance carrier?
Originally, insurance carriers placed that requirement on the insured, or patient. However, the physician can only provide the medical information that is often requested at the time of pre-certification. When pre-certification is not affirmed prior to admission, the party that suffers most is the hospital. As a result, most hospitals have taken on the responsibility of the pre-certification process. In some cases, hospitals can obtain pre-certification approval data from the physician instead of the carrier.
Q. How soon after filing an insurance claim should the follow-up process begin?
How quickly do you want to be paid? Insurance carriers pay providers sooner if the follow-up effort is prompt and persistent, squeaky wheel stuff. Providers can be rated by carriers as to their aggressiveness. Payment is made more promptly to the squeakiest. In Texas, lawmakers are helping the cause by passing prompt payment laws.
Q. How can we obtain answers to questions we have?
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