Why Is the Co-Pay I Collected Short By $20?
Posted on 06. Feb, 2010 by Editor in Coding Challenge
Verify co-pay early to save time, money
Question: A patient came to our office for a routine exam with the same insurance card she’s had for years. We charged her the standard copay of record. Then I found out her employer changed the terms of the insurance, so the copay she paid was short by $20. What went wrong?
Answer: You might easily assume that when a patient has the same insurance company, the copay is the same as it has always been. But unless you check first, you won’t know the patient’s coverage has changed until after the fact.
Best practice …Set up a process to verify each patient’s insurance information before every visit. The ideal time to verify with a patient or her insurance company is either before the appointment or when she arrives at your office. Devise a plan for how you will obtain patient information early on. Your options include connecting with the patient, a software program, or through the payer directly.
Finally, copy every patient’s insurance card every time. This simple step will put you in the clear for those times when a patient’s terms, copays, or precertification contact numbers have changed.
© Medical Office Billing & Collections Alert.
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Nidhi Maheshwari
13. Feb, 2010
In today’s economy where Insurers keep changing the plan and keep hiking the rates, patient is not going to inform the front desk about his/her increased copayments until the front desk staff asks. Its is more important now than ever that the eligibility and benefit verification be done everytime the patient walks in the door to ensure that small amounts like these are not missed out during collection. After all it all sums up!