Follow Up with Payers After Submitting Claims

It’s common sense that you should follow up with your payers after you send them claims... but many of us don’t do it. 

The sooner you know you have an issue with a claim, the sooner you get the issue addressed or researched.  How many HHA’s have lost money because they had a claim reject or deny and they didn’t have time to address the problem and lost the money?

One reason we don’t do follow up often enough is because it can be a tedious and time consuming process. Some payers have good web sites and customer service but many do not. 

Another reason is that many bosses get frustrated with the time it takes to follow up with payers.

So what can you do to help make following up on claims less frustrating and more practical?

Steps to Follow-up with Payers

• Get organized – How do I follow up with my payer? Am I registered and good to go? How do I keep my registration current? Am I oriented to the payer web site? Do I know where to find information on eligibility, claims and authorizations? Do I have a spreadsheet or notebook where all this information is organized and accessible?
• Take notes. Whenever you learn something new, write it down so you have it.
• Utilize information on Payer Websites.  A lot of payer website have useful information on submitting claims and how to address claim errors.  Study these web sites and download the information when possible.  (I like to copy PDF manual files to my tablet device to read at my convenience). 
• Set aside time every week for claim follow up with Payers.  An hour every morning? Tuesday and Thursday afternoon?  Put claim follow up with Payers on your schedule and stick to it.
• Get support from the boss. Some bosses are not patient with the time it takes to follow up with payers so you need to explain the importance (to get “buy in” from the boss). Use real life examples, ask the boss to do the follow up once or twice so they understand how long it can take.
• Have a strategy when you call customer service. I always have my agency and customer information ready and I’m logged into the payer web site when I call. Stick to facts and don’t get emotional. The person at the other end of the phone won’t help you if your screaming at them. Be very clear about what your question is. Be prepared to call.

Bear in mind that the more you do anything the easier it gets. The more you work with certain payers the more familiar you get with their websites and claim requirements, the smoother working together going forward will go.

Rules keep changing and just getting the claims out the door in the first place can be tedious and time consuming in and of itself.

All Billers: Importance of follow up.

You can’t assume just because you “send” a claim it’s going to pay in this day and age. It’s a lot easier to just click “send” in your software and forget it but billing claims these days is complex to have that luxury.

 Do you know how to follow up on claims for all your payers?  Are you currently registered on the web sites? Are you signed up for emails from the payer if offered? Do you have a good, efficient system for tracking and following up on all claims and especially denied and rejected claims? (if not you should get a system).