Pro-Active Approach to ENT Medical Claims SubmissionMost Ear Nose and Throat (ENT) practices and clinics are looking for new ways to be more successful and improve ENT claims submissions. After all, a medical practice is still a business, and if cash flow is slowed or halted for any reason, it becomes difficult to pay the bills. Clinical coding optimization and support for current medical codes and regulations can be beneficial in this area if you do your medical billing in-house. While some practices opt to outsource billing to streamline the process, there are things that you can do to improve the way that your staff does things and ensure that everyone is up on the requirements for Otolaryngology ICD-10 coding.

Daily Claims Filing

For many who work in the healthcare industry, submitting claims in the current climate can be challenging. Each insurance payer has its own set of rules, requirements, and paperwork that must be completed in order to receive payment and benefits. Some procedures require a pre-approval before treatment can begin. Not following the rules has consequences, which can end up costing your practice time and money. Because only a small percentage of claims are paid the first time they are filed, it is essential to perform claims submissions on a daily basis to stay on track.

To reduce the number of rejected, denied, or returned claims, education and training are essential. The change from ICD-9 to Otolaryngology ICD-10 coding, as well as several other modifications within the insurance industry, have caused many practices to fall behind. Implementing a standard for daily claims submissions can help your team stay on top of submissions without it becoming overwhelming. Delegate a certain amount of time each day to ensure that claims are properly handled and submitted to reduce errors and consider providing training and support to help your team stay abreast of current medical codes and regulations.

Open or Unpaid Claims

Take advantage of the tools included in your medical billing system to stay on top of open or unpaid claims. Routinely check on any claims that are still open at least once a month. This will help your staff to know the status of each account and provide them with the opportunity to resubmit the claim or contact the insurance company to ensure payment is made. If any claims are still unpaid within 60 days, make sure your team knows to make a phone call. This can prevent misunderstandings or bad habits that could be causing the same claim to have to be made over and over again without any positive results.

Clinical coding optimization and professional support can help to improve ENT claims submissions and ensure that your team is up on current medical codes and regulations. Sometimes a simple phone call is all that is needed to prevent any issues that might be causing a claim from being processed and paid. Building a relationship with third-party payers is essential. MD Pro Solutions can assist our clients in ensuring that Otolaryngology ICD-10 coding is accurate and provide services that can help to streamline and simplify the process of claims submissions and collections.

Patient Collections

Another great way to be pro-active and ensure that your practice or clinic gets paid properly is to work with your staff regarding co-payments and deductibles that come directly from the patients. Save time and money by collecting the co-payment and any deductibles that the patient is responsible for at the office before the appointment. Every time you send out a bill or statement to a patient, it costs you money. You can reduce the time invested and the cost of sending out these reminders just by taking care of this at the office.

Keeping patient insurance coverage and contact information up-to-date is also highly recommended. While it may be annoying to some patients, collecting this data at every visit can be extremely beneficial. Staff should also check the patient’s information with the insurance companies between visits or when the patient contacts them to set an appointment. This will help you know the exact amount of the co-pay and the amount of co-insurance deductible that is required. Get a copy of the patient’s card front and back to prevent issues and improve ENT claims submissions across the board.

If you are ready to become more pro-active in your approach to Otolaryngology ICD-10 coding, claims submissions, and collections, contact MD Pro Solutions. We can assist you and your team with education, training, and support to ensure that everyone knows the current medical codes and regulations. Help with clinical coding optimization, ENT account management, and other specialized areas is also available. Give us a call at 508-946-1665 to learn more about our services or to get started with a FREE evaluation.