The pressure of releasing a claim on time is no joke. Medical institutions are after their concerned teams to get the money of the claim at the earliest. And, for that they are adopting strategies which might work very well at times and completely fail on other occasions. In fact, in some cases even after submitting the cleaner claim, reimbursements can be delayed due to lack of follow-up. So, hospitals and other healthcare practices need a better scheme to win a game. But, before jumping on to the better game plan we should try to spot the problems at the ground level.
What is Going Wrong?
Gone are the days, when the medical billing staff would simply inform the insurance provider about the claim rejections or denials without making an effort for the clearance. Today, medical workforce has to supervise the complete revenue cycle process steps for claim, right from the submissions to follow-up and then finally clearance. And, in the entire series, follow-ups play a vital role. But, to make it more effective and seamless a separate team for claims follow-ups should be put in place by medical institutions. This team’s prime responsibility should be effective follow-ups. They should have the clear vision about when to start follow-ups, how to reach out to the insurance companies and get the clearance done.
In addition to having an effective follow-up team, a proactive follow-up policy should also be designed and followed. This policy will help the resources to constructively reach out to the insurance companies and remind them about the claims. Policy should have clearly written objectives, steps and the procedures of how to handle denied or rejected claims. This will not only ensure uniformity in the actions but will also be the base of successful claims.
If the team member does not know when not to follow-up then this can create a problem. For instance consider a scenario wherein a claim is already is in process, and the company has just decided to clear it out at the earliest, but your employee is continuously reminding the insurance company about the clearance of the claim. In such cases, don’t you think that the action will not only increase your cost but also put you in bad light with regards to the insurance provider? Hence, this ‘not to follow’ tip can never be ignored.
So, you need to plan a good follow-up strategy and execute it well. For better approach and proven strategies with regards to the entire claims processing cycle, you can get in touch with MedbillingExperts. We are experts in designing seamless claims processing services, which will help you in applying the best plans and get the claims released faster.
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