I have just come on board with a practice who has struggled with billing and am working on recovering as much of their aging A/R as possible. After 2 months of working on the AR (there's about .5 mil in total), the provider is frustrated that more hasn't been done. I initially explained that to get the process completed where we could comfortably call the A/R "resolved" would take anywhere between 6-12 months. The provider initially agreed, but now insists that the work could be done in half the time by rebilling claims to insurance companies, even if they've already been billed. He said it's better to rebill the carrier and say we "forgot" we already billed them. I understand this goes against billing best practices, but how do I explain that to him? The payers will ultimately deny claims as duplicates, but doesn't that process also actually make the process take longer, not speed it up? How do you deal with difficult providers who think they know better?
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Wiki Aging A/R and duplicate billing
- Thread starter mocisara
- Start date
Orthocoderpgu
True Blue
If you follow your physician's advice you will just slow down the process significantly. I would appeal to him/her that way. Physician's think "all you have to do is bill the claim" and it will be paid. Nothing could be further from the truth. If you have already billed without payment, their must be something that the insurance company needs in order to process the claim. They may need info from the patient, or past medical records. PEC form, accident form. The fastest way to clear up the A/R is to find out what is needed. Just billing everything out again will slow you down working duplicate denials rather than spending your time on something that will get you closer to payment.
amdjohnson126
Guest
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I have a couple of questions regarding the aging A/R are these all denied claims? Or are these claims with no response and are sitting as an open balance ? If they are denials then you should be able to pull reports to see if there is a common issue going on . Common procedure code , common modifier , ect. sometimes the same denial over and over indicates something else is going . If these are open balances with no response from the payer then that may be a system issue where claims never made it to the payer. If that is the case then rebilling is the next step.
SharonCollachi
Guest
I had this same, frustrating conversation recently (with someone who asked me for advice, not someone I work for). I told them if you just rebill claims, then the majority of them will deny for duplicate, because you don't have the claim ID number on the rebill. He said, just put it on there. I told him it has to come from the original claim, so if you can put your hands on the original claim, then you might as well work the whole claim.