Claims Follow up Is Crucial

Claims Follow up Is Crucial

One of the most common mistakes practices make is to set up an automatic rebill of unpaid claims without researching claim status. This will cause duplicate claim denials.

Most payers provide the ability to check claim status online, or automated over the phone. Staff should follow up on claim status when payment has not been received.

Perform payment posting when the remittance advice is received. Staff assigned to payment posting must verify the correct payment has been received. Most practice management/billing systems have a feature for automated payment posting. For this process to work correctly, and to avoid underpayment, best practice is to load the fee schedule for each payer so that when an incorrect payment is received, it is identified on a report for research by a biller or A/R representative.

Another common error by practices is to not post zero payments. These are your denial. If they are not posted, you have no way to know that the claim was denied. Post the zero payment and the denial remark code so you can generate reports to determine total dollars associated with, and the reasons for, denials.

2017-code-book-bundles-728x90-01

John Verhovshek

John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.
John Verhovshek

About Has 402 Posts

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

Leave a Reply

Your email address will not be published. Required fields are marked *