14 Feb Pre-Collection Vs Post-Collection Denial Management
Benefits of Pre-collection practices in Denial Management and further monitoring insurance claims in clinics and hospitals.
Clinics and hospitals take insurance denials seriously, but many of them don’t make it a point to manage these denials quickly. In fact, clinics and hospitals practice post-collection denial, hence can only take action several weeks after the claim is billed. This might not seem like a big deal on the surface, but those who look closer will see that post-collection denial management actually results in increased A/R days and a lower bottom line. This can result to lower client satisfaction levels and poor cash flow for the affected business.
Fortunately, hospital or clinic owners can turn the tables around by adopting pre-collection practices. This would involve following up claims within the first couple of weeks of filing. This might sound too early but, in reality, it’s never too early to monitor insurance claims.
Benefits of Pre-collection practices
Implementing pre-collection strategies propel insurance providers to pay more attention to claims. Insurance companies receive thousands and even millions of claims every day. It is difficult for them to give personalized service to each claim. To avoid this practitioners can bring the claim in the insurance firm’s attention and urge them to process it soon.
Pre-collection provides clinics and hospitals with plenty of time to rework and resubmit claims if denied. Once they know the status of their claims, they can immediately analyze why these were denied and take the right steps to rectify them. These can involve getting correct information from patients (such as their date of birth and insurance ID number) and applying the correct medical code to the services or procedures that were rendered. Once they gather information, they can resubmit their claims and hopefully have them accepted by the insurance provider.
High claim success rates benefit the clinic or hospital in many ways. It decreases the chance of writing off debts and increases the chance of getting the reimbursement that are due. It also increases the amount collected from insurance companies, improves bottom line, maintains a positive cash flow and increases patient satisfaction. Since denials are managed and turned into approved cases before EOBs and ERAs are generated, patients have a positive experience and build stronger client loyalty.
Medical practitioners can implement pre-collection denial management techniques on their own. However, its best to work with a company that specializes in these strategies. This way, they will have experts who’ll follow up on their claims.