Medical Office Payment And Billing Tips

26 Apr

If you are a physician or nurse practitioner and want to branch out to start your own practice, then there are many things that you will need to consider. One important thing you need to figure out is how to implement your medical billing practices. Medical billing can be confusing and it is wise to work with a medical billing service to make sure every patient’s insurance company is billed properly. However, there are some important things you need to do within your office as well.

Run Insurance Verification

The Affordable Care Act has allowed individuals to sign up with a wide variety of different insurance companies. There are about 35 main insurance companies in the United States. While it may seem as though there are hundreds of them, most companies are actually a division of one of the 35 companies. Each division is state specific with sign up available through the individual marketplace.

While each insurance company division is a part of a bigger corporation, you should know that every specific company will have its own sets of copayments, deductibles, and payment structures in place. These structures are inline with the regulations of the Affordable Care Act depending on the package and level of care chosen by the individual. 

With different insurance companies offering different packages and allowing people to choose new options each year, it can be confusing as to which insurance provider each patient is using during their visits. You should always run an insurance verification to see if the patient has continued coverage through the same insurance provider since they last visited the office. You will need to implement electronic medical records software for this. Ask receptionists to verify insurance before the appointment and ask for new cards and insurance information if verification fails.

In some cases, patients may not know that their insurance is invalid. In particular, cancelling of insurance for nonpayment is something that can happen quickly and without prior communication. It is best to work out these issues before the appointment or you may not receive payment for the services.

Collect At The Time Of Appointment

If you implement and use a good electronic medical record software system, then you should be able to determine the necessary copay immediately. It is wise to collect the copay at the time of the appointment and before the insurance company is billed. You also may want to ask for a deposit if a deductible applies as well as payments for outstanding balances.

To help you collect payments, set up a check out procedure where each patient must speak with a receptionist or office assistance before they leave the office. If payments are not made, then the patient should be informed clearly of when a payment or copay is expected. Some medical offices also charge late fees for balances that are not paid within about 30 days. You may want to consider this if you think that timely payments may be an issue. For more information, contact companies like Premium Medical Billing Inc.

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