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No Surprises

NEW COURSE! | Be Compliant with the No Surprises Act

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OIG

There's no need to fear the OIG. We've got your back!

The most effective chiropractic OIG compliance programs are scaled according to the size of the practice!

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Proactive Calling: Proper Use of Your Aging Report

Proactive Calling: Proper Use of Your Aging Report

Proactive aging calls are generated when we notice a balance on our aging report or unpaid claims report and have no idea why it is there. These generally require a call to the carrier to review outstanding bills or dates of service to determine where the payment is and why it hasn’t been received.

Most practice management software systems use an aging report to identify balances and how long they have been due. An internal procedure may be set up so that each month the balances are either automatically moved forward to 30, 60, 90, or 120 days, or this process may take place as you process your month-end procedures on the computer. Either way, it’s important to stay on top of these balances so that you are aware of the average age of each balance in each payer class for each patient in your system.

Managing Your Report

Identify your aging report by payer class. Some software systems allow for unpaid claims and aged accounts receivable to be viewed on the computer. Others need to be printed. Ideally, sort on the screen or print according to the following categories being placed into their own individual reports.

  • Medicare
  • Blue Cross Blue Shield or the carrier with your largest group of insured patients
  • Other commercial carriers
  • Personal injury
  • Workers’ compensation
  • Cash patients
  • All other types

Where possible, print or sort according to balances—highest to lowest—rather than in alphabetical order. It’s important to work the most productive balances first, especially if you are just beginning an aging report procedure. If you can’t sort by balance, it’s helpful to sort by insurance carrier. This puts all of the outstanding balances for a certain carrier next to each other on the report. This system makes it easy to address all of that carrier’s patients while you’re on the phone with them rather than making multiple calls.

Only seek to find accounts with balances that are at least 30 days old. This will make your aging report much smaller and you won’t waste time on bills that are most likely not ready to be paid.

If working with a paper system, save your reports in individual three ring binders if possible. If using a single, large binder, separate the reports by payer class with tabs. Each month, when you print a new aging report, put the newest month on top of the older one. This way you can track your progress. This also makes it easier for doctors or office managers to review aging reports on a monthly basis.

It’s Time to Work It!

Schedule time to make calls. Allow proactive calling time in your financial department’s schedule to work with your aging report. Depending on the size of your A/R and practice, you may need to allot as many as six to nine hours-a-week for proactive calling.

We recommend the following sequence as you prepare for proactive aging report phone calls:

  1. Review the insurance information in the computer. Gather the appropriate phone number(s), claim number(s), ID number, and any other pertinent information to begin a call.
  2. Call the insurance company. Let the representative know that you’re calling to check the status of an unpaid bill. Typically, the representative asks for the insured’s name, the patient’s name if different, the dates of service in question, etc. If you have done your prep work, you are ready to provide that information quickly and efficiently.
  3. Address everything related to that patient or payer. While you have the adjuster or customer service representative on the phone, take time to clear up all outstanding bills and claims for that patient.
  4. Document your call. Take whatever action steps are necessary; make notes on the internal financial record; include who you spoke to and list reference numbers that might be needed in the future.
  5. Update your Tickler File or other reminder system. Note when follow up is necessary.

If you have not been making proactive calls, and you decide to initiate a new procedure, be prepared for the first few months to take time—you’ll be able to move through them faster after you learn the system. The most important thing is that you simply to act on each item. If you find that a balance is due from a patient, don’t just skip over it. Verify that the balance is accurate, and that the patient has been getting a statement. If the patient has been ignoring the balance, bring it to the front desk team members’ attention so it can be addressed or consult your current policy on patient statements.

The KMC University Follow-Up process establishes a reproducible system in your practice. Proactive calling is simply one step in the process. Click the following links to learn more about TICKLER follow up and REACTIVE actions. We love to teach this system to both new and experienced team members. Interested in our instructor-led, online billing training course? Click HERE to arrange a time with our Solutions Specialist to learn more.

 

Call (855) 832-6562 now or click to schedule a 15-minute Solution Consultation at your convenience.

 

 

 

 

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Great speaker with valuable information.

Cindy Johnson Kricko