Medical Providers, You Can Get Paid

Do you think because you are a medical provider you are automatically paid when you bill the medical insurance companies? 

The insurance companies come up with reasons not to pay your insurance claims.

Your staff the people who work in your office and the ones which bill the insurance companies will need to be on top of every piece of paper or Explanation of Benefits (EOB) received from the insurance companies. This is where the detective work is to be able to read and decipher what the denials mean. These denials are the blueprint into how to get your insurance claims paid.

It sounds like such an easy thing to say and do but in reality it isn’t. I was once on a job interview and the woman who was interviewing me asked if I was organized.

I said, “Yes.”

She then proceeded to tell me that the person who was handling insurance billing and follow-up for that medical practice was sticking every piece of paper received from the insurance companies in a big garbage bag. This was the reason the medical practice was not making any money because without following up on the EOB’s there isn’t any payment. The question was what would I do with the EOB’s which were still in the garbage bag and still coming in daily.

My answer was this, “I would alphabetize all the EOB’s in a folder. There was more than one denial for each patient. These all needed to be chronologically put in order by name and date of service.”

She did not like my answer but to be truthful I didn’t know how else to solve the problem. The EOB by the patient’s name and date of service will explain to you line by line why the claim was not paid.

Now everything is electronically online and can be looked up by insurance company patient’s name and date of service to find out this information. The EOB’s still come into the office and if they are read and taken care of immediately there will be a cash flow into the medical office.

Linda Meckler, author copyright 2017