Course 158 Tips to Getting Paid

Tips to Getting Paid
Check insurance benefits for every patient before they come in
Take a new customer’s insurance information over the phone when you schedule their first visit so you can check their benefits prior to their first treatment. This will:
a. Let you know if they have massage therapy benefits. If they don’t, you will eliminate a patient visit that is not covered. The patient may still come in as a cash client.
b. Give you accurate co-pay, co-insurance, and deductible information so you can inform the patient of their benefits if they do not know.
c. Allow you to collect monies due from the patient at the first visit.
d. Inform you and the patient if they need a prescription, referral, or pre-authorization.
Pay close attention to the prescription details
a. Make sure that the therapist is treating and charting the patient based on the diagnosis.
b. Stay within the prescriptions limits including date range or duration and number of treatments. Once a prescription is exhausted a new prescription will be needed for additional therapy before continuing treatments.
c. Be sure that the prescription contains the information necessary for the insurance company to accept it. This includes number of visits, duration, and an acceptable diagnosis. Many insurance companies will not cover chronic conditions.
Collect patient payments in a timely and professional manner.
a. Always collect a patient’s co-pay at the time of service.
b. Collect co-insurance and deductible amounts at the time of service when they are known and it is allowed by the insurance company.
c. Apply payments to a patient’s account accurately by crediting the correct dates of service and writing off the contracted discount.
d. Notify a patient immediately if claims process differently than the quoted benefits or there is an issue with processing their claims.
e. Set up a monthly patient billing day for example the 15th of each month. Bill all patients that have patient-owed outstanding accounts receivables every month on the same day. It is allowable to add an interest or finance charges for accounts that are over 30 days past due if you provide regular invoices.
f. If a patient has not made a payment after two billing cycles contact the patient by phone. Be helpful and professional when communicating with a patient about an unpaid balance. Often a patient believes that their insurance company is responsible for payment. Send a pre-collections letter at three to four billing cycles. Be willing to work with a patient who is making an honest attempt to satisfy their outstanding balance. Send to collections if no attempt has been made by the patient to rectify their account.
Use a reputable collection agency that collects a percentage after receiving payment from the customer.
Typically they take 40% of the amount paid. Because there are statutes of limitation and collections are most successful within 90 days past due, it important to transfer delinquent accounts in a timely manner.
Watch patient accounts receivables closely.
a. Investigate in a timely manner claims that are not being paid. Do not let a patient’s account balance accumulate. Often there is an issue with their benefits or coverage and the patient is unaware that they may be responsible for payment.
b. Take accurate notes and record in patient’s file, all communication with or about a patient account. This may include calls to the referring physician’s office to request or update a referral, the insurance company to request benefit information or discuss a rejected claim, the patient, or their attorney regarding an unpaid balance. Record the date, the name of the person you spoke to, the dates of service in question, and detailed information regarding the conversation.
c. Be aware that the information you are given by the insurance company may not always be accurate. Ask specific questions. By doing so, the customer service representative may be able to resolve the issue over the phone.