When a customer changes insurance¸ your next move sets you up for either a smooth transition, or multiple touch points and lost revenue. Which do you choose? The former or the latter? Obviously, we want the former (a smooth transition), but in practice, I see it every day, providers saddle themselves with the latter (multiple touch points and lost revenue).
We discussed the surest path to a smooth transition in our October blog Prevent Eligibility Snags. However, as is often the case, we stumble on changes in insurance when billing staff works a denial or rejection. If you are like most, you’ll set it and forget it. You’ll redirect the claim to the new payer and move on. It makes sense: the customer left Medicare and now has an HMO, so that new plan will reimburse us for the service, right? But you couldn’t be more wrong.
We discussed the surest path to a smooth transition in our October blog Prevent Eligibility Snags. However, as is often the case, we stumble on changes in insurance when billing staff works a denial or rejection. If you are like most, you’ll set it and forget it. You’ll redirect the claim to the new payer and move on. It makes sense: the customer left Medicare and now has an HMO, so that new plan will reimburse us for the service, right? But you couldn’t be more wrong.
The new plan requires prior authorization and only pays network providers. Furthermore, the new plan doesn’t track payments made by Medicare – so we can start over at month 1. But we didn’t take any of this into consideration with the rebill protocol.
Setting claims to narrowly rebill to new payers invalidates past, present and future revenue. When policies change, you need a proper vetting and protocol to ensure the revenue stream stays steady and is maximized. You might have left countless rentals on the table, but that can stop today. Join us as we tackle the $$$ side of changing insurance on December 15 in our event “Are Insurance Changes Shortchanging Your Profits?”
Setting claims to narrowly rebill to new payers invalidates past, present and future revenue. When policies change, you need a proper vetting and protocol to ensure the revenue stream stays steady and is maximized. You might have left countless rentals on the table, but that can stop today. Join us as we tackle the $$$ side of changing insurance on December 15 in our event “Are Insurance Changes Shortchanging Your Profits?”
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