Although you’re undoubtedly in the healthcare industry to help improve people’s lives, that doesn’t mean you can let your clinic go underwater. You have to maintain balance to continue making a difference and that means maximizing payments across the board.

Unfortunately, denied claims can eat away at your revenues and leave you in the red by the end of the year. In fact, just claim denials alone result in a 10% loss or about $5 million per year for your average hospital.

A loss of 10% per year is even more devastating for practices, leaving you scrambling for a solution. Thankfully, reducing denied claims is easier than you might think — and you can learn just what to do from this informative guide.

Key Steps in Verifying Eligibility and Getting Payments

If you want to keep your practice generating positive revenues, you need patients and their insurance providers to make their payments on time and in full. When practices don’t have good revenue cycle management procedures in place, all that can go to the wayside. Fortunately, you can follow these steps to make sure that your practice receives all payments due and doesn’t lose money from denied claims.

Verify Eligibility While Setting Up Appointments

Minimizing claims denials all comes down to good healthcare revenue cycle management practices. This process starts from the second a patient reaches out to schedule their appointment. From that moment on, it’s up to your team to verify eligibility and get payments processed.

For that reason, it is important to have your team verify eligibility before scheduling each patient’s appointment. They will need to collect their insurance information, look at the group numbers and plans, and even explore patient deductibles and benefits.

Beyond that, the scheduling team needs to verify that the healthcare insurance coverage is still in effect and covers the services in question. If the patient does not have any visits left for physical therapy, for example, then they need to let them know it will require payment out of pocket.

Collect Payments in Full at the Time of Service

Slow or incomplete payments can eat into your practices’ revenues, leaving you without the means to continue your endeavors. Thankfully, it doesn’t need to be that way. You just have to clearly communicate expectations to each patient and collect payments in full at the time of service.

You can start by putting all your financial policies, including the upfront payment requirement, in your welcome packet. As patients read through that information, they will learn their responsibilities as your patient and be ready to make their payment at the time of service.

After that, you just need your staff to follow payment collection procedures for every visit. They will need to understand the co-pay totals for each insurance plan and collect that payment upfront. If patients elect to pay out of pocket, they will need to collect the balance at check in to effectively support your revenue cycle management goals.

Consider Keeping Payment Information on File

Many patients do not want to make their payments at the time of service, but if your office offers to keep their payment information on file in a secure, PCI-DSS certified gateway, you can streamline that process for them.

With that move, all your staff has to do is let the patient know about their balance that’s due and ask to process it at that time. You can even go one step further and let your patients know you’ll charge their card on file as soon as their insurance company processes their claim.

Need Help Reducing Claim Denials? Look to Health Revenue 360, LLC

Now that you know what to do, you just have to integrate the steps into your everyday operations. Your staff will need comprehensive training to get up to speed on your new policies. If that task feels insurmountable, it might be time to reach out for assistance.

As one of the leading revenue cycle management companies, Health Revenue 360, LLC, is always poised to help. We can help you work with your patients to ensure they are eligible before coming in for their visit.

You can trust that we will personalize our services to the needs of your clinic and handle all the details for your team. With our support, you can direct your focus from billing and revenue protection to helping people improve their health and wellness.