l1ttle_0ne
Guru
Our company has hired a consultant to help work our old AR. She is advising us to do a blanket rebill of all unpaid claims ever month. Any thoughts on this?? Can this be considered fradulent to keep rebilling claims??
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Wiki Blanket rebill?
- Thread starter l1ttle_0ne
- Start date
My opinion 
In my opinion I wouldn't say it's fraudulent, but if you all you are doing is just rebilling all your unpaid claims every month, you are not doing anything for your AR. I understand rebilling everything that is 60+ days out right now, so you can get any timely filing denials, duplicate denials, etc. to work and get off your AR.
I also understand rebilling your 61-90 days claims monthly if you have not been paid or have not received a denial, so you can get that claim on file with the insurance and stay with-in your timely filing limit.
If you are constantly dealing with insurances not having your claims on file maybe there is something wrong with your electronic claims and/or your clearing house.
The first thing I would do is, rebill everything 60+ days out, then start calling on EVERYTHING that is 120 days and over then move to your more current claims!!! If you just rebill everything you are going to end up with alot of 'duplicate' denials and essentially be in the same place you are in now.
My office is working hard on our AR as well, since its gotten a little out of hand, the best thing we have done is simply to call on each one. You will be surprised on the outcomes there will be.
Hope this helps!
ChicaD
In my opinion I wouldn't say it's fraudulent, but if you all you are doing is just rebilling all your unpaid claims every month, you are not doing anything for your AR. I understand rebilling everything that is 60+ days out right now, so you can get any timely filing denials, duplicate denials, etc. to work and get off your AR.
I also understand rebilling your 61-90 days claims monthly if you have not been paid or have not received a denial, so you can get that claim on file with the insurance and stay with-in your timely filing limit.
If you are constantly dealing with insurances not having your claims on file maybe there is something wrong with your electronic claims and/or your clearing house.
The first thing I would do is, rebill everything 60+ days out, then start calling on EVERYTHING that is 120 days and over then move to your more current claims!!! If you just rebill everything you are going to end up with alot of 'duplicate' denials and essentially be in the same place you are in now.
My office is working hard on our AR as well, since its gotten a little out of hand, the best thing we have done is simply to call on each one. You will be surprised on the outcomes there will be.
Hope this helps!
ChicaD
I do the A/R in our practice of 5 OBGYN's. I will do a full A/R every month and focus on all the claims still on the account with balances. There are several things I look for.
1- Were claims generated and successfully filed electronically?
2- If they are over the 30 days I will log on to the payers websites and see if they have the claim on file.
If they do not, I will check our electronic filing service and see if the claim were sent and received by the payer. Or why they were rejected by the payer.
Based on that it will determine if I will just refile the claim to save us from timely filing or if I have to call the insurance and do additional follow up.
When I view the claims online and check the remittance advice and claim status I can actually post a lot of claims that were applied to the patients deductible. Or I find checks that were sent and not posted/received. We have a corporate office that receives payments and posts them. This is the reason I may have to track down payments and such.
I would not recommend blanket billing. If you have that many you need to look for the pattern of why they are not being filed correctly. The payer ids and insurance may not be loaded in the computer correctly either. In this case even if you do refile all of them they may be not reaching the payer at all.
Every practice is different though. This I find works best for us even though it is time consuming. I find that we have a better payout and turn around. Also we are able to notify the patient quicker to have them follow up if they are denied for certain reason.
1- Were claims generated and successfully filed electronically?
2- If they are over the 30 days I will log on to the payers websites and see if they have the claim on file.
If they do not, I will check our electronic filing service and see if the claim were sent and received by the payer. Or why they were rejected by the payer.
Based on that it will determine if I will just refile the claim to save us from timely filing or if I have to call the insurance and do additional follow up.
When I view the claims online and check the remittance advice and claim status I can actually post a lot of claims that were applied to the patients deductible. Or I find checks that were sent and not posted/received. We have a corporate office that receives payments and posts them. This is the reason I may have to track down payments and such.
I would not recommend blanket billing. If you have that many you need to look for the pattern of why they are not being filed correctly. The payer ids and insurance may not be loaded in the computer correctly either. In this case even if you do refile all of them they may be not reaching the payer at all.
Every practice is different though. This I find works best for us even though it is time consuming. I find that we have a better payout and turn around. Also we are able to notify the patient quicker to have them follow up if they are denied for certain reason.
MonarchMedBill
Guest
Another thought...
While I agree this would not be considered fraudulent, it could be considered abuse in regards to government programs. While it is slightly time consuming, it might be best to see if a claim is on file before doing a blanket rebill to avoid a possible audit.
While I agree this would not be considered fraudulent, it could be considered abuse in regards to government programs. While it is slightly time consuming, it might be best to see if a claim is on file before doing a blanket rebill to avoid a possible audit.
Cynthia Hughes
Expert
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Blanket rebilling
I have a lot of experience in working as a temporary employee who cleaned up old A/R and also as a manager of a billing service. Advice to blanket re-bill is not good advice in my opinion. The only way to be sure the claim was correctly filed to right payer is to work each individual claim until you discover that you have a "batch" problem where correcting a single issue and rebilling all associated claims should result in payment. Sending a claim that is rejecting for an error without making a correction is wasting time on the timely filing clock. Only a correctly filed claim shows proof of timely filing. Working old A/R is tedious but I have seen it result not only in receipt of potentially lost revenue but also demonstrate gaps in the procedures for maintaining patient information and in billing processes that if undetected, would result in continued lost revenue.
That's my soap box speech for today. Hope it is helpful.
Cindy
I have a lot of experience in working as a temporary employee who cleaned up old A/R and also as a manager of a billing service. Advice to blanket re-bill is not good advice in my opinion. The only way to be sure the claim was correctly filed to right payer is to work each individual claim until you discover that you have a "batch" problem where correcting a single issue and rebilling all associated claims should result in payment. Sending a claim that is rejecting for an error without making a correction is wasting time on the timely filing clock. Only a correctly filed claim shows proof of timely filing. Working old A/R is tedious but I have seen it result not only in receipt of potentially lost revenue but also demonstrate gaps in the procedures for maintaining patient information and in billing processes that if undetected, would result in continued lost revenue.
That's my soap box speech for today. Hope it is helpful.
Cindy