Insurance Collections Outline

This post sponsored by
Common Ground Chiropractic Center.
2927 NE Everett Street, Portland, OR 97232.
503-232-4099 commongroundpdx.com

Gary Shannon here.

This is a linked list of articles on Insurance Collections in this blog

These articles in outline form as of October 2010.

Sign up to this blog to get a copy any of them as they are written.

Ask to sponsor one for $27.00 if you need one written right away.

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Keywords and Concepts:

• Insurance, Benefit, Premium, Payor, Underwriting
• Deductible, Co-Pay, Maximum, Out-Of-Pocket, Usual & Customary
• Benefit, Assignment of Benefits
• Provider Types: Preferred, Participating, MMO, Referral, Primary Care
  
• Primary Insurance, Secondary Insurance, Third Party Insurance
• Personal Injury, Major Medical, Worker's Comp, Group Insurance
  
• Diganosis, ICD, Procedure, CPT, Preexisting condition,

Reading an Explanation of Benefits

• Commonalities and Differences
• Adjustment codes
• Missing EOB

Insurance Verifying

• Workspace: Phone, on-line.
• Key Questions
• Record Keeping

Insurance Audit

• 4 steps: service delivered, claim sent, patient co-pay, insurance benefit
• 4 results: Paid Fair, Paid Poorly, No Payment, No Answer
• 4 actions: Patient collect, re-bill, write-off, or defer

Rebilling tricks, simplest to most complex

• New Claim & Repeat Claim
• Tracer
• Corrected Claim -change in code or diagnosis
• Send additional charts and data (PIPA, WC827,
  
• Primary/Secondary EOB
• Phone call. Anti-duplicate
• Payor Recourse: Supervisor Intervention, Complaint Department, Review
  
• Other Recourse: State Complaints, Dispute Resolution, Employer Intervention,
  

All the best to you and yours.

This post sponsored by
Common Ground Chiropractic Center.
2927 NE Everett Street, Portland, OR 97232.
503-232-4099 commongroundpdx.com