e-MDs Front Desk Tips For Maximizing Revenue: Part 2
Mr. Jones is coming in today for a follow up appointment. He walks in the door whistling a happy tune. “Good morning Clara!” he says to your front desk person.
“Good morning Mr. Jones. How are you today?”
“Fantastic! I hope you are too!”
“I am, thanks for asking.”
“Anything changed on your insurance or address?”
“No, other than I’m a bit older than the last time I was in here!”, he says with a genuine smile.
“Great! I’ll get your $20 copay and then you can have a seat.” Clara collects the $20.00 bill from Mr. Jones, prints a receipt from the pre-pay screen, hands it to Mr. Jones who takes it and sits down in the corner to watch the latest episode of The Kelly Show. A few minutes later he is called back and seen. One his way out he smiles at Clara and says, “Thanks a million!” and walks straight out the door without a hitch in his step. The practice just lost $85.00. Wait WHAT?!?! Mr. Jones is very clever. He quit his job recently and decided to take a few months off. He isn’t on a COBRA plan and is currently uninsured. Your front desk person doesn’t know that though. UNLESS… they have done an eligibility check to see if Mr. Jones still has benefits. Sadly, in this case, eligibility wasn’t run and $85.00+ just walked out the door. It’s not just the $85.00 of the $100.00 allowed amount that is now not going to be paid by Blue Cross because his coverage was terminated 2 months ago, it’s the time your billing staff will spend receiving and posting the denial. Your billing staff will also spend researching why the denial took place. There will be time spent to call the patient and request his new insurance card. Then there’s the phone call that he won’t answer. The flipping to patient responsibility and patient statement cost that the practice will now incur. So, we are well over $100.00 in staff time, postage, statement printing costs, etc. All of which could have been prevented by running eligibility. If that happens once a week, that’s over $5000.00 in lost profits.
Having said the above, most practices are running the eligibility batch function through their clearinghouse or they are going to payor websites to check patient eligibility. That’s terrific! Then why this article you might ask? The reason for the article is that while most practices are running the report, they are not giving the data to the front desk staff to collect the money from the patient. In most cases, the billing staff runs those eligibility files and turns the little circles in the schedule red, yellow, or green. However, the little dots don’t mean much to most untrained front desk personnel.
The bottom line, run your eligibility batches on a daily basis. Gather the data. Put that data into your front desk staff’s hands so they can greet the patient and know if they are still insured, not eligible, or haven’t met their deductible.
Mr. Jones may be sly, but with eligibility data at its disposal, your front desk team will outsmart him every time!