Wednesday, August 29, 2018

Family File Accuracy



Having trouble getting a claim paid? Are you even sure it was received?

The easiest way to be sure claims process and are paid with ease, the first time, is to make Family File accuracy a priority!

Typos are easy to make. Mistakes happen. Be sure you and your staff are taking their time and verifying that all entered information is accurate. Here are some common things to pay close attention to that will avoid delays and errors.

1. When entering a patients NAME, be sure first and last are right, spelled correctly and match what the current insurance plan has on file.  An accurate family file is a crucial part of the success of your practice. When this information is correct, and updated regularly, claims will be received and paid correctly.  This saves everyone time and energy and increases revenue for the practice.

2. It is imperative that the patients DATE OF BIRTH be entered correctly. One wrong number makes all the difference. 

3. Current INSURANCE coverage information must be verified on or before each visit! Who is the subscriber? The correct family member must be entered as the SUBSCRIBER, and the subscriber ID needs to be accurate. Make sure you are checking whether it is family or individual plan. Do they have a secondary? Subscriber information must be accurate for each plan. Before entering each plan, verify which is primary and secondary. 

4. Most of our plans today use electronic filing.  This feature is quick, easy and convenient. BUT- it only works when the correct PAYER ID is entered. The first time the insurance coverage is entered, the correct payer ID should also be included. When verifying coverage on or before appointments, the payor ID can very easily be confirmed as well. When having an issue with a claim, this should be one of the first things checked.

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