Getting around insurance carriers' stall tactics is important in today's envirnoment and follow up is essential. Each client is assigned an Account Rerpresentative who work diligently following up on your claims by phone, not by simply re-billing a claim to the carrier.
The Insurance Collections process begins as early as 15 days from filing using our Task Mananger reporting, we are able to priotitize accounts for our collectors. Patients are tracked by actions taken and noted on each account for easy followup to ensure that payment is received. ‘
If the insurance company has issued a denial we determine if an appeal should be made and send an appeal if it is appropriate. We then follow our process for appeals and exceptions.
The Guarantor Collections process begins with a letter being mailed. Checks are in place to ensure they have the correct information within the letter (i.e. 1st, 2nd, 3rd round collections letters). A call is immediately made to the guarantor since response by mail is sometimes minimal and we want to collect as soon as possible. If payment is collected over phone the payment will be processed and the patient will no longer be on the collections list in ‘Task Manager.’ If payment is not collected then collectors handle common objections accordingly. Our collectors are trained on what questions to ask, information to provide, and steps to take with each common objection. A payment plan may be set up with a guarantor if paying in full is not an option. The payment plan option will vary by group and will be determined based on your client’s preference and the feasibility of POP executing that preference. Our software, PPM Plus, is equipped to set up a payment plan in this event. If a payment plan does not get agreed upon and after the phone call(s) and 3 statements requesting payment have been made the claim will go to an external collection agency. Patients that are on a payment plan, but miss 3 consecutive payments, will go to the external agency as well.