This is why we strongly recommend that every healthcare providers' office has a policy for confirming patient demographic information, as well as obtaining insurance information at each visit for every patient.
If you are a healthcare provider, and you are not doing this, it will result in financial losses for your office.
When patient demographics and insurance information is NOT collected at every visit, for every patient, your practice revenue can easily be impacted in the following ways.
Missed billing opportunities: Without up-to-date insurance information, claims cannot be submitted in a timely manner and payment is delayed. This can lead to missed reimbursements from insurance companies and a loss of revenue for the practice. Collecting insurance information at each visit ensures that billing can be done promptly and accurately right away.
Inaccurate billing: Insurance coverage can change over time due to policy updates, changes in employment, or modifications to the patient's insurance plan. Failing to collect updated insurance information at each visit can lead to billing inaccuracies. This includes submitting claims with incorrect policy details, outdated coverage information, or invalid insurance identification numbers. Inaccurate billing leads to claim denials and delays in reimbursement.
Increased denied claims: When a claim is submitted to a terminated insurance policy, it takes time to receive a denial, adjust the account, and request the updated information from the patient. Since insurance companies often require claims to be submitted within specific timeframes. If insurance information is not collected at each visit, there is a higher risk of delayed claim submission or past timely filing denials. This results in increased claim denials, increased patient statement costs, and a possibility that payment will never be received.
Unpaid patient balances: Verifying insurance coverage also helps in determining the patient's financial responsibility, such as copayments, deductibles, or co-insurance amounts. By not collecting this information at each visit, the practice is missing an opportunity to collect payments from patients at the time of the visit. Unpaid patient balances accumulate over time and can easily result in significant financial losses for the practice. Once a patient walks out the door, the chances of collecting payment drops significantly.
Increased administrative costs: Failing to collect insurance information at each visit leads to additional administrative work. Staff may need to spend extra time following up with patients, contacting insurance companies for verification, or resolving billing errors. This increased administrative burden results in higher costs for the practice and reduced efficiency in revenue cycle management.
Limited understanding of insurance coverage: Collecting insurance information at each visit, and even verifying benefits prior to the visit, allows the practice to have a comprehensive understanding of the patient's insurance coverage. This knowledge enables the staff to educate patients about their benefits, coverage limitations, and any pre-authorization requirements. Without this information, patients may be unaware of their insurance rights and what they are expected to pay after insurance for the service. This can lead to patient dissatisfaction and resistance to paying for the services when they are billed after insurance.
It is crucial for a every healthcare providers' office to prioritize the regular collection, and verification, of insurance information at each visit to minimize financial losses, ensure accurate billing, and maintain a healthy revenue cycle management process.
Here at Priority Medical Billing, Inc, we work with each healthcare provider to help teach them how to implement the best office policies to ensure revenue is being maximized, and patient satisfaction is at its highest.
For more information on maximizing your revenue please contact us at email@example.com or call 708.362.6080 ext 1001.