Our experience with medical recovery has revealed many problems and resolutions for the recovery of individual medical payments from both individuals and insurance companies.
The battle between the Insurance carriers and medical facilities continues to rise. As a result many patients are left uneducated as to when they are responsible for a bill and when they are not. Patients moving from one plan to another, because their employers can not afford the ever-increasing premiums, have left many consumers unaware as to where their benefits begin and where they end.
In collecting on medical claims, Kross, Lieberman & Stone has found that under staffing, miscoding, uneducated consumers, contractual write-offs, and extended aging has created cash-flow problems for many medical facilities. We have taken the burden of communicating with patients and the need to review their EOB's off the administrative staff of many doctors offices and hospitals.
KLS is aware that creating cash flow is important in every industry. Time-lines for filing with certain carriers as a courtesy to patients can create an atmosphere of 'skimming' the bulk of the claims as filed with insurance as hurriedly as possible. The priority for self-pay and remaining balances after insurance pays then becomes less important in relation to the day-to-day responsibilities of most in-house collections staff.
KLS have found that the Days Outstanding for medical claims is as important as any industry out there.
As the above chart explains the chance of recovery on claims over 60 days decreases as the account ages. If your recovery percentages are low, consider placing claims earlier. The difference between collection and write-off can be dramatic especially if there is even the chance that a balance of a claim can be collected through the re-filing of insurance under a corrected code, second and third insurances being followed-up with, and merely explaining unpaid balances and balances due to your patients in terms they understand. Your staff can not verify every mailing address and phone number, they can not resolve every minor problem in the midst of handling the day-to-day collection issues at time of service, nor can they follow-up on every claim with a remaining balance after insurance has paid, Kross, Lieberman & Stone can.
Make Kross, Lieberman & Stone apart of your early-recovery and resolution team. Review our various services as we reveal how we can increase your cash recovery.