Are your claims being worked properly? 

When a claim or service is denied or partially paid:

• Does your staff simply write off the balance?   or
• Do they properly appeal the claim with the correct documentation and forms?  or
• Do they simply hit the “rebill” button and hope that the claims are paid the second or third time around? 

Did you know that over 20% to 30% of all claims filed are never “received” by the insurance company?  They mysteriously get lost between your office and the insurance company requiring additional staff time to follow-up.  Most practices are struggling to keep up with the day-to-day work even if they are fortunate enough to have a competent and qualified staff. 

Are you maximizing your reimbursement potential?

• How much of your gross charges are you actually collecting?

Depending on your fee schedule pricing and your contracts, you should (on average) collect 65% to 75% of your gross charges.  This means that for every dollar you bill to insurance companies, you should deposit about $0.65 to $0.75 in your account after writes-offs and contractual adjustments.  In addition, if your A/R over 90 days is more than 20% of your total outstanding A/R, you are losing significant practice income. 

• At DBA and WCDB, 10% over 90 days is our goal.  In 2006, we averaged 9% for all of our practices;  50% of our practices averaged under 6%!

 

Related resources

• Are you a candidate?
• Why Outsource?
• About Our Billing Service