AquinaSeptember 26, 2016

Strategies for Getting Paid Faster on Outstanding Claims

Strategies for Getting Paid Faster on Outstanding Claims

One of the biggest challenges facing every healthcare business owners is improving their payments on outstanding claims to government and insurance payers.  Whether it is Medicare or Medicaid or a private insurer, claims can take weeks or even months to process.  Even small errors in submission can lead to longer delays.  Fortunately there are a number of key strategies that can improve your experience and speed up your payments.

Diligent upfront work is one of the key strategies for improving your payments on outstanding claims.  Business owners need to work with their front office staff to insure they understand the importance of preclearing patients through their government or insurance payers.  Billing staff should make sure they understand a patient’s benefits and what amount the payer will cover for each procedure under your contract.  There are a number of good software packages to help with the pre-qualification of patients that will also help with the billing and coding.  Correct upfront coding of claims is often the best way to insure swift payment.

Another key strategy to improve the timing of payment on claims is to diligently manage your claims’ denials.  You should have dedicated resources internally who are responsible for working with any claims that get denied by the insurance or government payers.  The follow-up  items on these denials need to be handled as soon as the denial is received, and your team needs to have ready access to the information needed to state your case for payment.  Having a dedicated team that is knowledgeable about billing practices can speed up payments for your practice.

A final strategy to pursue to get paid faster on your claims is to utilize a financing facility that gives you control over the timing of your payments.  Medical practices can work with a specialty finance company that will put in place a factoring line that allows the business owner to select outstanding claims for early payment. Through this type of arrangement, outstanding claims are sold at a small discount to their expected payment amount, and the practice gains immediate access to the cash for any business purpose.  While this strategy does have an explicit cost for the discount fee, it offers the business owner the most flexibility in running their practice.

Provider Web Capital has developed an innovative claims finance facility called ATM. Through Remit ATM, medical practice owners can identify individual claims to receive early payment.  It is as easy as taking a withdrawal from the ATM machine for your business. Please contact us at (855) 860-9700 or visit us on our website at www.providerwebcapital.com to learn more.