Avoid the Trickle-down Effect From Registration Errors

Avoid the Trickle-down Effect From Registration Errors

A smooth, error-free revenue cycle starts at the front desk.

Your front desk registration staff is the first stop in the ever-revolving revenue cycle. Collecting the correct information before a patient’s visit is critical to avoiding a slow-down in the billing process, denials, patient frustration, and ultimately loss of revenue for your practice.

Errors in demographics and insurance information trickle down through the entire revenue cycle, from payment posting to denial management, and possibly even sending billing statements back to your patient. This can ultimately affect timely filing limits, the aging of accounts receivable, and your provider’s benchmarks.

Let’s look at some common errors that occur during registration and some ways to prevent those errors from occurring.

Recognize Common Denial Reasons

The most common denial remark codes due to registration errors are:

  • Expenses incurred after coverage terminated
  • Expenses incurred during a lapse in coverage
  • Claim denied as patient cannot be identified as our insured
  • Claim/service not covered by this payer
  • Secondary payment cannot be considered without the identity of the primary payer

There are steps you can take to avoid these types of denials and improve patient satisfaction.

Collect the Right Information at the Right Time

Verifying eligibility prior to the appointment and then confirming this same information once the patient checks in can do wonders for your accounts receivable.

When a patient arrives, your registration staff should ask questions to retrieve the patient’s demographics and then verbally verify the information back to them.

Medicare beneficiaries with a Medicare Advantage plan are the most susceptible to an error in this questioning. If the registration staff asks, “Do you still have Medicare?” the patient is likely to say yes, but they could have recently changed from traditional fee-for-service (FFS) Medicare to a Medicare replacement plan.

In a 2019 WPS Government Health Administrators’ conference, the speaker said one of the most common denial remarks is “Claim not covered by this payer, you must send the claim to the correct payer/contractor.” This signals to the provider’s office that the patient does not have traditional FFS Medicare. It is also one of the easier denials to avoid, by simply confirming whether the patient has a Medicare replacement plan at the time of service.

Ask the Right Questions to Get the Answers You Need

Coordination of benefits (COB) issues can be the most time-consuming and costly to resolve. Often, the patient has to reach out to the insurance company and straighten out a COB issue.

It is not only essential that the insurance information is correct, but also the order in which it is sequenced on the claim. Medicare contractors provide us with the Medicare Secondary Payer (MSP) Questionnaire, which can be used by the front desk staff when there is more than one insurance for a Medicare patient. This questionnaire helps identify the primary payer by asking questions related to the patient’s other insurance.

Stay on Track

Your front desk staff is the first line of defense against registration errors. Setting standards and continuing education for your registration staff can help the back end of the revenue cycle, which equates to fewer denials, less patient frustration, and preventing lost revenue.


Resource:

Medicare Secondary Payer (MSP) Questionnaire. 2020. WPS GHA.
www.wpsgha.com/wps/portal/mac/site/claims/guides-and-resources/msp-questionnaire

Marissa McClure
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Marissa McClure, CPC, CPB, is a medical coder in Indianapolis, Ind. She previously worked as a denial management biller and A/R specialist. McClure is a subject matter expert for Certified Professional Biller (CPB™) products and a member of the Greenwood, Ind. local chapter.

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