Half of the errors we see at RADMAX today could easily be avoided by facilities putting better emphasis on the front-end patient registration piece! In today’s Managed Care world of healthcare, getting the correct patient information is vital to getting paid! Also, patients must be authorized for all services. Even Government plans like Medicare and Medicaid are being managed more-and-more by private insurance companies (Advantage Plans) and require prior authorization for treatment.
Things to remember when the patient comes into your office:
- Get accurate information from the patient (including a copy of the patient’s insurance card).
- Make sure the patient is authorized for all treatment.
- Make sure the patient has a PCP (primary care physician) referral.
- Check the patient’s benefits closely for deductible amounts and out of pocket expenses like co-pays and co-insurance (and make it routine to re-check on future visits).
If you follow these steps you have a much greater chance of getting your claims paid the first time you submit them to the insurance company. And your billing company (entity) will appreciate you for making their job easier also!