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February 2020 Client Newsletter

Credit Care On File (CCOF)
Many patient visits require collection of a co-pay, deductible, or co-insurance. This is especially true of the recent high deductible plans. The current medical environment payment process is this:
  • Patient calls for an appointment (New or Established)
  • Receptionist obtains or verifies the insurance information on the phone, then electronically verifies it is still active, amount of deductible (if any), amount of deductible met, the amount of co-pay or co-insurance.
  • If patient has valid insurance, the appointment is made & the patient is reminded to bring their $X co-payment and reminded that their deductible has not been met and remind them that the appropriate amount of their deductible will also be due on the date of service. If the patient has any other outstanding balances, an attempt should be made to obtain payment over the phone.
  • If the patient does NOT have insurance, the patient is given the amount of the basic appointment (New vs. Established) and the minimum amount that will be owed. Payment is collected upon arrival prior to be seen for New patients.
  • On the date of service, upon arrival of the patient, collect all co-pays/co-insurances that are expected prior to being seen.
 All good so far. But the past year or so a new payment process has arrived: Credit Card on File (CCOF) that simplifies and speeds up payments even more. Cape Billing already offers eStatements.
Getting your patients to sign up for automatic payments with CCOF is the next step. When you are ready to do this, give Rich a call.
As you probably know, Aetna is moving nationally from NaviNet to Availity for their eligibility and other functions. NJ is in the 1st group.
As a member of HBMA, I also serve on the Insurance company committee. We have direct access to high level Aetna, CIGNA, UHC & Humana staff.
If you have issues with this change, and are not able to resolve the issue at the local rep level, let me know and I will assist.
Scheduler Users
Just a reminder for our Scheduler users. In order to keep the database searches be fast, annually we move patients who have not been treated in the last 5 years to an "Archived" status. That removes them from the "Active" database so the program has less data to sort through.
BUT, we know that occasionally patients return to the practice for various reasons. When that happens, just call Cape & let whoever answers the phone know that patient needs to be moved back to the Active database. It will take less than a minute to do.
Reminder: 2020 only a testing year for AUC
From MGMA 1/16/20:
"Some medical group practices have been told to immediately purchase and use Clinical Decision Support Mechanism (CDSM) software to comply with the Appropriate Use Criteria (AUC) program, with vendors suggesting that claims payment would be impacted in 2020. In a posting on its website, the Centers for Medicare & Medicaid Services (CMS) reiterated that 2020 is an educational and operational testing period and there are no payment consequences this year.
The AUC program will require ordering professionals to consult CDSM software for certain advanced imaging tests and require rendering professionals to include that consultation code on their Medicare claims starting in 2021. Practices are encouraged, however, to plan for implementation of CDSM software and test workflows at some point this year."
2020 Client Newsletter Archive