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Following up on Claims

  1. #1
    Default Following up on Claims
    Medical Coding Books
    I am curious how everyone has implemented their "follow up team" - staff that calls on outstanding claims, checking claim status, correcting denials, etc...As we all know, follow up is time time time consuming!, cumbersome, and none the less, tedious.

    i.e. Do you outsource your A/R?, Do the payment posters work the A/R?, Do you have a dedicated staff member(s) who solely work the A/R?

    We are thinking about restructuring this and would love to know how others do it and how successful they are.

    Also, how do you measure individual follow up staff's productivity? what are your standards? Tracking mechanisms are very expensive. Of course we could keep track of, "Susie followed up on 200 claims today", but if she's not making any money off those 200 claims, it does us no good.
    I would love to be able to say .... "For the month of august, Susie brought us in $20K from follow up on claims" Does anyone track it like that?

    I would love everyone to share their experiences!!!!

  2. #2
    We have dedicated staff that handles the A/R. There are 3 of them in our office of 7 Orthopods. We have the A/R divided by insurance carriers, eaching having their own to work. We do monitor the A/R but not in quite the detail that you mention. The are required to turn in an A/r report at the end of the month. I audit all of their write offs to make sure they are not writing off things that are appealable. We report an overall percentage of collections to the docs but we do look at the individual percentages as well.

  3. #3
    mbort, when you say a/r report at the end of the month - do your staff keep a log of claims they have followed up on? is it computer generated by user? what does that report consist of from a follow up perspective?

    thanks so much

  4. #4
    it is a computer generated A/R report, they print one at the beginning and at the end of the month. Throughout the month while they are working their report, they are writing on the one they printed at the beginning of the month and then they turn in both at the end of the month so that we can look at the reasoning and what they are doing to get the 90+ paid on. If while calling on a claim and the carrier states let say "claim is set to pay in 3 days", then they notate that so we can see it while reviewing their report.

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