April 2010 Client NewsletterAETNA
On March 16th Aetna announced via email (forwarded to all clients that have provided us with email addresses) that beginning June 14, 2010 they will no longer send paper EOBâ€™s. CPB is already set up for most clients and will work with whomever necessary to ensure a smooth transition.
However, please note that if you still wish to have paper EOBâ€™s that you can complete an â€œExclusion formâ€. Of course, weâ€™ll be glad to do that for you â€“ just let me know.
CPB really needs a copy of all authorizations when you receive them (if not already sent with the charges) so we can update info in the notes. We get quite a few Horizon denials for no auth (usually, but not always, after the first auth is no longer valid). In all cases, we need the initial auth and all subsequent auths to be sent to CPB with charges or when received. That will provide us with the information needed to get claims paid without needing to contact your office for the information. Better cash flow, no interruption for either office, and more efficient for everyone.
Of course, if the charge requires an authorization and you do not have one yet, please hold it until the authorization is received. Insurers wonâ€™t pay without the auth # anyway.
On March 23, 2010, President Obama signed legislation that extended the Therapy Cap Exceptions Process until December 31, 2010.
CHALLENGING ECONOMIC TIMES - Maximizing REVENUE
The best way to improve your patient collections is to be proactive. Here are a few common ways to do that:
Â· Collecting deductibles and co-insurances from patients without secondary insurance on the day of service.
Â· Collect copayments upon arrival of the patient â€“ before they see the provider. If you do not already have a sign in your waiting room that states "Payment is expected when services are rendered unless other arrangements are made in advance", you may want to consider adding one. If a patient arrives without cash, a check, or credit card, consider rescheduling their appointment (unless an emergency, of course) so they can bring their copayment, coinsurance, or any outstanding deductible. We have had clients who told us that when faced with having to reschedule, patients have gone to their car and miraculously found cash and credit cards!
This â€œtrainsâ€ the patient that this really is a firm policy and ensures timely payment. If questioned by patients, explain that it keeps the cost of running the practice down since mailing patient statements does cost money. Some discretion may be appropriate if this only happens rarely.
Â· Get a copy of all insurance cards and verify addresses and phone numbers each visit. Accurate information is required by insurers â€“ if what is received by them doesnâ€™t match their records, it will delay payment while they verify identity.
Â· Include all required authorizations with the charges â€“ no benefit to send the charges before we get the auth. Insurers wonâ€™t pay without it anyway.
Â· If an insurer is not paying, get the patient involved early. If the care is elective, delay further services until insurance issues are worked out and payments are made.
Â· Donâ€™t accept promises! Unless your creditors accept them. In which case, let all of us know! Of course, you can promise to treat the patient further when their insurance company pays.
One of the concerns we are hearing recently is patients who forget their appointments. Our software vendor has just released an â€œAuto-Dialerâ€ product that can be used with our appointment system to automatically call pts a day or 2 prior to their appt as a reminder. Expected to be ready to demo in early April.
They also released another new product called a â€œDigital Penâ€ which also is used with our appointment system. If you choose to use this product, CPB will cover the cost. Also expected to be ready to demo in early April.
Both of these products would improve the efficiency of your office and cash flow (patients who show up create revenue!). Please give Rich a call if you are interested.