To quote the Physicians Practice, “the revenue cycle starts with patient registration.” Regardless of your practice’s billing system (in-house vs. outsourced), there are steps you can take to ensure your claims are processed quickly and correctly—the first one being effective patient registration.
When a patient calls to schedule an appointment, your front office staff should ask a series of questions. That way they can collect pertinent billing and insurance information. If you have patient registration forms online, staff should encourage patients to complete the forms in advance. Physicians Practice recommends also following up with patients if online registration isn’t completed at least two days before the appointment. This will ensure your staff can verify the patient’s insurance before he or she arrives for the appointment.
So what do you need to know prior to that patient arriving for his or her appointment? Here are ten questions you should be able to answer about each patient:
- What is the patient’s primary and, if applicable, secondary insurance coverage?
- Does the patient’s insurance plan cover physical, occupational, and/or speech therapy services?
- Is there a yearly visit limit for physical, occupational, and/or speech therapy? If so, how many visits has the patient already used and who do you need to speak with to obtain authorization for additional visits?
- What is the copayment, coinsurance, or deductible that will apply to this service, and what amount of the deductible has the patient already met?
- What network is used to price claims for this plan?
- What is the unique payer ID for electronic claim submission? If you’re submitting paper claims (and here is why you shouldn’t), what is the insurance company’s mailing address?
- Does the patient’s insurance company require that you send advance notification or plan of treatment to a review company? If so, what information do you need to include for approval?
- Will the patient need additional information or medical records submitted with each worker’s compensation or liability coverage claim, or does the payer prefer a periodic records review?
- What is the timely filing requirement?
- Who should you call for claims follow-up?
If billing starts with patient registration, then an effective registration process is key to an efficient billing process. Make sure you’re starting your billing off on the right foot.
What patient registration advice do you have? Share in the comments below.