The Collection Process in Medical Billing Francie Walters Jennifer Randall.
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Transcript of The Collection Process in Medical Billing Francie Walters Jennifer Randall.
![Page 1: The Collection Process in Medical Billing Francie Walters Jennifer Randall.](https://reader035.fdocuments.in/reader035/viewer/2022062322/56649ec75503460f94bd2a87/html5/thumbnails/1.jpg)
The Collection Process in Medical Billing
Francie Walters
Jennifer Randall
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Alternate Title
How to get the Most out of your Receivables!
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What we will Cover
• Establishing a collection program at your lab• The collection module in MB and how it works• The aging reports in MB • What the collection process looks like at
Northeast Dermatopathology• General Discussion about what works in your lab
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Establish a Collection Plan
• Before you can begin the collection process in MB you should first determine your specific companies collection plan both for patient account balances and for insurance account balances.
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Questions to answer in developing your patient collection process.
• How much time will you give a patient to pay their bill before it enters the collection process?
• How many statements should a patient receive before entering the collection process?
• Will you allow the patient to make payments?• Will you make any internal collection attempts, ie
phone calls before you begin the MB collection process?
• What is the minimum balance you will attempt to collect?
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What we do at NDI
• We allow 75 days from the date the patient received the first bill to pay the balance.
• We want the patient to receive a minimum of 2 statements.
• The patient will not enter the collection process if they have made a payment in the last 30 days.
• We make no additional attempts to collect prior to the patient entering the collection process.
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The Collection and Aging Module
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Prepare the Aging Table
NOTE: AGING YOUR RECEIVABLES HAS NO EFFECT ON THE MEDICAL BILLING COLLECTION PROCESS!!!!
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Aging based on Print Date vs Date of Service
• Aging based on Print Date will age your receivables based on the FIRST patient statement or the LAST claim generated
• Aging based on Service Date will age your receivables based solely on the number of days since the date of service
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The 5 step collection process in Medical Billing
• The collection process in MB should be run monthly.
• Phase One or steps 1 and 2 are done at the start of the process
• Phase Two or steps 3 thru 5 are done approximately 15 to 20 days after Phase one.
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A Possible Time Line
• June 1, 2014– Age the receivable based on the Print Date– Run the first two steps in the collection
process, Generate the Pre-Collection Records and Print the Pre-Collection Letters
• June 20, 2014– Run Steps 3 thru 5, Generate Collection
Records, Send Accounts to Collection, Write off Overdue Accounts
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Step 1Generate Pre-Collection Records
Sets Credit Status to 2 on the Patient Demographics screen
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The Credit Status Code
• The credit status field is updated as the account moves through the collection process. This field is stored in the patient demographics tab.
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Pre-Collection Report• Review For
Medicare Patients
• Review for Full Balances
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You can cease the collection process by changing
the credit status to none.
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Generate the Pre-Collection Letters
Tip: We print the pre-collection letters on bright gold paper Credit Status Field advances to 3
Phase One is Complete
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Generate Collection Records
Credit Status Code Advances to 5
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Send Accounts to Collections
Credit Status Code Advances to 6
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Write off Overdue Accounts
Posts the Adjustment to the Service and Sets Service to a 40Changes the Credit Status Code from 6 to 7 to none
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What we do at NDI after the account is written off
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NDI Timeline for September Collections
• Sept 2, 2014 – we run the pre-collection program and send the precollection letters
• Sept 16, 2014 – we run phase 2 of the collection process
• Oct 1, 2014 – We make calls to all delinquent accounts where no payment has been made
• Oct 10, 2014 – We send personalized letters to collection accounts.
• Oct 20, 2014, We send final collection letter (same letter to all accounts)
• Oct 31, 2014 we send any outstanding collection accounts to an outside agency.
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Payer Aging Detail Report
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Why is the claim still Open?
There are only three reasons an insurance
claim should be over 90 days old:
• There was no response from the insurance company (happens a lot on secondary claims or paper claims)
• The claim was denied and never addressed
• There was a posting error on the account
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“Tools” That assist in working our Aging Reports
• Scanning our Request Slips
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Tools” That assist in working our Aging Reports
• Websites we use daily:
• Zirmed
• Promise (PA Medical Assistance Site)
• Navinet
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“Tools” That assist in working our Aging Reports
• Zirmed • Electronic Claims• Credit Card Processing• Electronic Payments• Eligibility• Medicare• Blue Shield (Other than the local
Blue Shield)• Humana• Miscellaneous Insurance
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“Tools” That assist in working our Aging Reports
• Navinet
• Claims Status and Eligibility
• Local Blue Shield Plans
• Geisinger
• Aetna
• United Health Care
• Cigna
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“Tools” That assist in working our Aging Reports
• PROMISE
• Pennsylvania Medical Assistance
• Claim Entry, Eligibility
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In ClosingWhat I learned!!!!
• Aging has no bearing on the MB collection Process.
• 75 days is too long before they enter the collection process
• Our write off process is valuable and worth the time and effort
• The importance of alternating the aging of your receivables
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QUESTIONS?