Help Your Staff
You must help your staff do whatever is needed to get the information and payments from the patients before it is too late. If a patient has a referral that will not allow you to perform important diagnostic tests, don’t try spending money paying your staff to hunt down another referral with more codes/tests on it, have the patient schedule the additional tests at another time when you will be reimbursed for services rendered.
Give the patient an information sheet telling them what to give/fax to their primary care physician so that they can get the important/proper tests done to aid in the care of their medical problem.
Staff Chasing Referrals
Your staff running around begging/chasing referrals when a patient is in the chair is wasting your time, your staffs’ time, and your money. The patient’s insurance plan is at fault. They want you to separate the visits, that is how they pay.
If you want to do the testing for free, then do it the same day as the consult (if you don’t already have a proper referral) if not then schedule the tests on another day to give time for the patient to get the proper detailed referral done. Your staff should be doing testing on patients plans that either have already approved it or at least allow it on the day you wish to do these tests. If you feel the patient can’t safely wait until another day for the tests, then this becomes urgent/or emergent and then most HMO plans allowed for 48 hours to get the referral from the PCP (If the PCP will do it). In most cases however, when medical notes are reviewed it is found these tests could have waited a few days and the insurance will not pay for the testing.
Patients Best Interest
Specialist prefer to run the diagnostic tests to get the answers so they may render a proper medical opinion and also do what is in the best interest of the patient’s health. Sometimes if seems that HMO type care has another goal in mind. Be that as it may, specialists must come to understand that most of their appointments are not emergent, that specialized testing can wait till you can get proper referrals/authorizations, and that their staff’s time is better spent working on the “paying” patients that are in the office now and keeping the patient flow going, and not having to “go fishing” for referrals.
If a specialists really thinks that the patient’s immediate health is in jeopardy, then at least the doctor knows they may be doing this test for free … but at least they know that ahead of time. Your staff calling and begging/demanding a referral for this and that, is not the best marketing tool for increasing referrals from that practice. You won’t loose just the HMO referrals, if you or your staff irritate the PCP’s office, you will loose on the total referrals.
About EYE Bill FOR YOU
Based in Virginia with 54 years of combined experience and a broad range of medical billing knowledge, EYE Bill For You offers HIPAA compliant medical billing for many specialties. Our medical billing outsourcing solution is offered in the Virginia, Washington DC and Maryland areas.
Cathy Boddie (owner) has an established reputation for helping doctors lower their accounts receivables by examining super-bills and improving them to increase reimbursement levels. Cathy has taught students in medical billing and coding at Northern Virginia Community. Cathy has provided lectures and training sessions on medical billing and coding, Self Pay Issues, and working with Embassies accounts at Georgetown University Hospital and Medical Center.
http://www.eyebillforyou.com
EYE BILL FOR YOU
Cathy Boddie, Owner
email: cathy@eyebillforyou.com
phone: 877-EYE-BILL or 877-393-2455
For permission to republish the above article, please contact Cathy Boddie.
