When a claim isn’t paid in a timely manner, your billers need to document communication with the payer and follow up with e-mails, said Ann S. Deters, MBA, CPA, CEO and founder of SevenD & Associates, an Effingham, IL-based consulting and management company affiliated with 17 surgery centers. Deters spoke at the recent annual meeting of the Federated Ambulatory Surgery Association.
Hold the payers accountable, she emphasized. Communicate with them regularly, and follow through with your communication. Be friendly, but firm, Deters suggested. "Say, If I don’t receive this in a week, I will be calling you back so you can check and see where my check is,’" she advised.
Don’t be led astray by excuses, she suggested. If needed, involve the supervisor of the person you’re communicating with, Deters said. If you aren’t satisfied after talking with that person, speak to the supervisor at the next level, she advised. "They will pay it once you get the higher-ups involved," she said.
The last straw is to hold them to the contract, Deters added. "They need to pay you within the contract terms, which is typically 30-60 days," she said. "You need to review your contracts, and your collector needs to be on top of your contracts to ensure that they’re not abusing their rights."