Before Writing Off a Balance: What Healthcare Practices Should Consider
Before Writing Off a Balance: What Healthcare Practices Should Consider An outstanding patient balance has remained unpaid for several months. The practice has sent statements, reviewed the account, and made appropriate attempts to resolve the amount. Eventually, someone must decide what happens next. Should the practice continue collection efforts? Does the balance qualify for financial […]
Not Every Denied Claim Needs an Appeal: Choosing the Right Next Step
Not Every Denied Claim Needs an Appeal: Choosing the Right Next Step A healthcare practice receives a claim denial for a service that was properly documented and submitted. The billing team reviews the payer’s explanation and believes the claim should have been paid. An appeal seems like the obvious next step. But before preparing additional […]
When a Valid Claim Misses the Deadline: The Revenue Risk of Timely Filing
When a Valid Claim Misses the Deadline: The Revenue Risk of Timely Filing A healthcare provider delivers a covered service, documents the visit, and expects to receive reimbursement. The claim is legitimate. The patient’s insurance was active, the service was performed, and the necessary billing information is available. But when the claim finally reaches the […]
Two Insurance Plans, One Claim: Where Secondary Billing Can Go Wrong
Two Insurance Plans, One Claim: Where Secondary Billing Can Go Wrong Having two health insurance plans may provide a patient with additional coverage. But for a healthcare practice, managing a claim involving more than one insurer can introduce questions that do not exist when only one payer is involved. Which insurance company is responsible for […]
How Do You Know If a Revenue Cycle Improvement Is Actually Working?
How Do You Know If a Revenue Cycle Improvement Is Actually Working? A healthcare practice introduces a new billing procedure. The team receives training, responsibilities are adjusted, and management begins reviewing the results. A few weeks later, employees report that the new process feels more organized. Claims are being reviewed more consistently, and certain tasks […]
What Payer Payment Patterns Can Reveal About Practice Revenue
What Payer Payment Patterns Can Reveal About Practice Revenue A healthcare practice reviews its monthly collections and sees that revenue is relatively stable. Payments are coming in. Claims are being processed. The overall numbers do not appear particularly concerning. But a closer look reveals something different. One insurance payer consistently takes longer to reimburse claims […]
When the Same Claim Denial Keeps Coming Back
When the Same Claim Denial Keeps Coming Back A claim is denied. The billing team reviews the explanation, makes a correction, and submits it again. The issue appears to be resolved. Then another claim receives the same denial. A few days later, the problem appears again, involving a different patient but the same payer or […]
What Patients Wish They Understood Before Receiving a Medical Bill
What Patients Wish They Understood Before Receiving a Medical Bill A patient visits a healthcare provider, presents their insurance card, pays the required copayment, and leaves believing the financial part of the appointment has been handled. Several weeks later, a medical bill arrives. The amount is higher than expected. The statement shows an insurance payment, […]
A Paid Claim Doesn’t Always Mean a Resolved Account
A Paid Claim Doesn’t Always Mean a Resolved Account A claim has been processed. The insurance company has issued payment. The billing system shows that money has been received. At first glance, that looks like a completed transaction. But a few weeks later, a patient calls about an unexpected balance. The billing team reviews the […]
From Daily Friction to Better Practice Performance
From Daily Friction to Better Practice Performance Most operational problems do not begin as major problems. They begin as small interruptions. A staff member cannot find the information they need. An account moves between people without enough context. A claim requires the same research more than once. A patient question takes longer to answer than […]