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Strategic and Successful Follow-up of Denied Medical Bills

Strategic and Successful Follow-up of Denied Medical Bills

Effective collections are directly subject to a strong follow-up, that result in the quicker resolution of medical claims.

The quicker the better, hence our follow up for the Claims begin 7 to 10 days after submission of a claim for payment. Instant efforts always reduce accounts receivable and get claims paid sooner and also increase cash flow.

The right kind of staffing with appropriate Medical Bill Collections training will always provide the desired outcome for your revenue cycle.

Our medical office staff is fully aware of the necessary steps for an efficient follow up on insurance claims.

Well prepared Initial Contact is very important to establish any correspondence after getting hold of the insurance representative, one must have all the information that you will need at your disposal and a thorough research of the account in order to ask the right questions i-e the date of birth, policy number, date of service, Tax ID and NPI etcetera- in addition to the name insured. This will allow you to provide feedback to the insurance provider as and when required.

Important relevant questions

Our goal is to find out the expected time of payment receipt. If you have not received a response for more than 30 days of the billing date, the insurance carrier representative should provide an explanation for the delay in payment. We make sure to ask important relevant and right questions to bring everything on record to ensure better future correspondence.

Such as:

  • Status of the claim?
  • Scheduled payment for the claim?
  • Payment process standings of the claim?
  • Payment amount of the claim?
  • Check the number of payments?
  • The reason for the delay to process the claim?
  • Correspondence point of contact for medical records?
  • How can we get this claim paid faster?
  • What is the cause of deviation from the contract to pay the claim?
Assertive plan of action

We are not afraid to challenge the insurance representatives through our extensive knowledge of the policies to prevent any tactical delay in payment.

We ensure while discussing a claim with an insurance representative to avoid any bogus information. We are not shy to escalate to any level of authority if any valid reason for the delay of claim payment not provided.

We find out any discrepancies and or invalid information that could hold the claim from immediate payment. Good rapport with the insurance representatives also helps to convince them to get more details about the claim usually.

Appropriate Action

We take appropriate actions to expedite the Medical Insurance Billing and payment process. It would usually depend on what kind of delaying tactics are you facing by the insurance company representative to delay payment.  We make sure there is a policy paper available at hand on top of the extensive training so our billing agents can quickly resolve any one of the following:

  • The claim was not filed
  • Review the medical records further
  • COB information for primary insurance
  • Member/Subscriber information
  • Prior authorization not available on the file
  • Referral information not on the file
  • Invalid or missing claim Information
  • Pre-existing information of the primary care physician
  • Medical necessity not mentioned
  • Accident details missing

Our goal is to make sure that your cash flow cycle does not get disturbed and you get paid for the hours you have put in – and your hard work is not denied in any way.

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