It may seem obvious, but it’s not. Follow-up with payers, if not you’re leaving money on the table. This is where our “defense team” shines!
Unresolved claims are the leading cause of lost revenue next to underpaid claims. Payers rely on providers not following up on claims, which lead to aged receivables, underpaid claims, and claims not fully adjudicated. We’ve got over 25 years’ experience, so we have seen it all! For example, we’ve seen payers process claims as “summer charges” – some’re here, some’re there, but not all – don’t get us started on low dollar claims that appear to go unnoticed; they can add up quickly!
But, we can help. We won’t just help with outstanding claims, we will review‘paid’ claims to ensure proper reimbursement was received based on fee schedules and modifier payment. We’ll search for trends that led to delayed or lost revenue. We’ll take on the follow up efforts, provide feedback, and assist in implementing preventive measures.