Insurance reimbursements are decreasing and operating costs are increasing, can make it a challenging time to manage a practice. Whether your practice has decided to do billing in-house or outsource it through an agency, getting paid while maintaining a relationship with your patients can be a balancing act at times. There are definitely some things to keep in mind in a practice to ensure that your practice is getting paid while still having the patient’s best interest in mind.
In Part One and Part Two of this blog series, we went over the importance of keeping detailed documentation, filing on time, updating patient information regularly, tracking your claims, and verifying new and potential patient information directly.
6. Know When Pre-Authorization is Needed
Like the time to submit a claim, different insurance companies have different rules for pre-authorization. Make sure any and all staff involved are aware of that and what different insurance companies want pre-authorization for. The best thing to do to keep the staff organized is to make a chart or list of your most used services and what insurance companies need pre-authorization for it. This way the answer can be found quickly without causing any disruption to the practice or make the patient wait longer than necessary if they are already in the office.
7. Educate All Support Staff
It is important to educate any support staff that helps carry out your billing on the correct medical codes for each and every service. You must ensure accuracy to avoid the claim getting denied by the insurance company. Keep your staff educated on yearly code updates and changes. Make sure your staff understands to avoid under coding or up-coding to be sure you are charging the correct amount for your practice’s services. Lastly, always be sure the service code matches the pre-authorization code.
We hope these seven tips assist your practice in billing!