The Aging
Posted by Sheri Harris on Sunday, April 11, 2010
Under: billing
With regard to medical billing the aging and collection of it does not have to be a paper trail or telephone nightmare. Currently this process occupies so much time that other tasks in the medical office are left unfinished. Medical billing has entered the electronic age and thus the aging and collection process should be made a bit easier. EMR software and clearinghouses should also be utilized for the aging and collections process.
IDEA:
What if aging software for medical EMR is integrated into billing software not only for generating reports as it currently does but for generating aging collection invoices and submission of delinquent accounts to collection vendors or clearinghouses?
The EMR and billing software should also include aging as a secondary billing or resubmission process. This is because when patients are billed there are times that in order to receive full payment or what the insurance company will pay out the billing of that visit will have to be resubmitted. Reasons for this are sometimes due to a correction in diagnosis, procedure, submission of physician notes, referral approval or adequate insurance information. These claims get lost in the shuffle of resubmission. By the time it takes to obtain the corrected information such claims have entered the aging category; of 30,60,90,120 days late or beyond for being balanced out or collected entirely.
When an aging tab is integrated as part of the billing and collection software it will be a lot easier to resubmit claims that are corrected electronically. This is because once you post a patient's account, the software will automatically tabulate any balance left unposted, unadjusted, not written-off ect and creates an aging report for each patient. The aging report is generated not only by showing the total amount due from each patient but it can also generate a report that will detail each service or procedure provided that the physician was not paid for, ie. co-pay,ekg, ect.
In example a physicians office submits a bill to an insurance company for the following services and or billing codes(cpt), 36415,93000,99214 along with a diagnosis code, 272.0,401.9,250.00.; the billing is submitted electronically. The insurance company will tabulate if the co-pay is collected along with the patient responsibility of deductible and co-insurance. The insurance company will then issue a check for the amount it is to pay the physician for that particular visit. If there is a discrepancy regarding diagnosis codes, out-of network benefits, covered services or any other payment issue the insurance company should provide clear and concise EOB information regarding each and every procedure and claim and why the payment was rejected. Once this information is received to the billing personnel, these amounts are posted. With the addition of aging software(aging tab) any service or procedure that was not adjusted, written-off ect to a balance of zero is resubmitted electronically now that billing personnel has the reason for the rejected claim and can now resubmit with the needed information that will result in payment from the insurance company. Money collected from the insurance company is again posted and another aging report is generated.
Once all money is collected from the insurance company as allowed for payment. The EOB will inform billing personnel how much they can now charge the patient according to his or her insurance plan. The aging invoice software will tabulate all amounts not balanced out to zero and will allow for billing personnel to submit procedures and amounts that a patient can be charged for or if the patient did not pay a co-pay or they still have to pay their deductible,co-insurance, not covered services or out of network services ect.. This invoice can then be submitted to the patient and constantly updated or tabulated for each visit a patient has with monies owed to the physician. The aging software will also keep track of invoices sent to each patient before it is decided upon by the physician that when bills remain unpaid upon issuing invoices then they are sent to collection. It would also be ideal that the billing clearing house also provide support in the collections process for delinquent payments. This will expedite such work and save a physician money by having the billing personnel submit any patient accounts that have outstanding balances electronically to the collections support staff as this is incorporated into the aging and collections portion of the software.
Medical billing can be cumbersome. Once you have the proper software to process payment, resubmissions including that of aging and unpaid invoices eventually submitted to collection; all billing can be processed and completed in a timely fashion.
IDEA:
What if aging software for medical EMR is integrated into billing software not only for generating reports as it currently does but for generating aging collection invoices and submission of delinquent accounts to collection vendors or clearinghouses?
The EMR and billing software should also include aging as a secondary billing or resubmission process. This is because when patients are billed there are times that in order to receive full payment or what the insurance company will pay out the billing of that visit will have to be resubmitted. Reasons for this are sometimes due to a correction in diagnosis, procedure, submission of physician notes, referral approval or adequate insurance information. These claims get lost in the shuffle of resubmission. By the time it takes to obtain the corrected information such claims have entered the aging category; of 30,60,90,120 days late or beyond for being balanced out or collected entirely.
When an aging tab is integrated as part of the billing and collection software it will be a lot easier to resubmit claims that are corrected electronically. This is because once you post a patient's account, the software will automatically tabulate any balance left unposted, unadjusted, not written-off ect and creates an aging report for each patient. The aging report is generated not only by showing the total amount due from each patient but it can also generate a report that will detail each service or procedure provided that the physician was not paid for, ie. co-pay,ekg, ect.
In example a physicians office submits a bill to an insurance company for the following services and or billing codes(cpt), 36415,93000,99214 along with a diagnosis code, 272.0,401.9,250.00.; the billing is submitted electronically. The insurance company will tabulate if the co-pay is collected along with the patient responsibility of deductible and co-insurance. The insurance company will then issue a check for the amount it is to pay the physician for that particular visit. If there is a discrepancy regarding diagnosis codes, out-of network benefits, covered services or any other payment issue the insurance company should provide clear and concise EOB information regarding each and every procedure and claim and why the payment was rejected. Once this information is received to the billing personnel, these amounts are posted. With the addition of aging software(aging tab) any service or procedure that was not adjusted, written-off ect to a balance of zero is resubmitted electronically now that billing personnel has the reason for the rejected claim and can now resubmit with the needed information that will result in payment from the insurance company. Money collected from the insurance company is again posted and another aging report is generated.
Once all money is collected from the insurance company as allowed for payment. The EOB will inform billing personnel how much they can now charge the patient according to his or her insurance plan. The aging invoice software will tabulate all amounts not balanced out to zero and will allow for billing personnel to submit procedures and amounts that a patient can be charged for or if the patient did not pay a co-pay or they still have to pay their deductible,co-insurance, not covered services or out of network services ect.. This invoice can then be submitted to the patient and constantly updated or tabulated for each visit a patient has with monies owed to the physician. The aging software will also keep track of invoices sent to each patient before it is decided upon by the physician that when bills remain unpaid upon issuing invoices then they are sent to collection. It would also be ideal that the billing clearing house also provide support in the collections process for delinquent payments. This will expedite such work and save a physician money by having the billing personnel submit any patient accounts that have outstanding balances electronically to the collections support staff as this is incorporated into the aging and collections portion of the software.
Medical billing can be cumbersome. Once you have the proper software to process payment, resubmissions including that of aging and unpaid invoices eventually submitted to collection; all billing can be processed and completed in a timely fashion.
In : billing