I think both Paul and Roy said it well. I have my own in house biller. She cares about each and every claim. As I am sure many of you know, the insurance companies play this game of "we never got it", "that claim was sent up to processing", "we need additional information before paying this claim". Any ploy to delay your payment or, better yet, fluster you so badly you just simply give up trying to get it. I am sure the amounts they never pay are staggering. My biller will not let them get away with even a penny. We run account receivable reports weekly as well as Unpaid Insurance Claim reports almost daily. She will then go through these with a fine-toothed comb and call the insurance companies. She will burn up the fax machine sending things they say they need or never got in the first place. She will stay on their butts until we fluster them and they pay the claim, as well as any finance charges (even if it is only a nickle) for a late payment on a proven clean claim. We almost never turn anything over to a collection agency as she is a ferocious collector. And, she can work the front office if needed. I have had billing services in the past and Paul is right...they have no real incentive to collect that $.30 balance. My billing program also gives me reports such as how many CPT codes I bill and what I get paid for each by each insurance plan I accept. I have dropped plans based on this data. When she posts, she can tell me immediately if something is being bundled. We then file a complaint with our state bureau of insurance and also I alter my exam habits. For instance, when Humana refuses to pay for a Pap done on the same day I see a diabetic, hypertensive with depression who comes in for their annual exam(because they claim it is included in the 99215 charge) I tell the patient we cannot do the Pap that day because of their insurance. The patient must then reschedule the Pap and pay another co-pay. This makes the patient mad, they put some heat on Humana and, finally, Humana quits bundling (as of this month!!) I can't tell you how many local teachers who have Humana badgered, called, and complained both to their Teacher's Union and to Humana. I simply refused to let Humana insinuate that my doing a Pap was not worth a dime while a gynecologist would get paid every time and that a complete exam on a male who did not get a Pap required the exact same amount of time, skill, sample processing and test review and therefore should be paid equally. Once again, gang, if you continue to let the insurance companies make up the rules, we shall all suffer. Anyway, back to the billing discussion...no one has more concern and interest in your bottom line than do you.
Leslie
