In order for the billing to be done effectively it is crucial that the relationship between the billing service and the provider’s office is a good one. Frequent communications with your providers is key to a good relationship. It is important to keep them abreast of everything that is going on with their billing and all that you are doing. When we first started our business we didn’t see the point in telling a provider that we were taking care of a denial or appealing a particularly difficult claim. We assumed he knew we were taking care of it. But experience showed us that this is not necessarily true and you need to find a way to keep your providers up to date on the status of their accounts without bothering them.
Some providers say they don’t want to know about the issues, but someone in the office should be watching for what the issues are. You don’t have to speak to the provider every time you communicate. You can have a weekly fax or email that just gives the highlights of the issues for the week. It is important that they know that any issues that come up are being taken care of and you are showing them this by your weekly communication.
When there is no communications between the provider and the biller, the provider may assume that the biller is not doing that much because the biller isn’t telling the provider about all the things that he or she is doing. It is amazing how many things we do for providers that they never realize. If you don’t let them know then they don’t know you did it and they don’t realize all the services they are getting.
We work for many small providers who don’t keep track of their claims payments. Their whole perception of what is getting paid and what is not getting paid is based upon two things. Do they have any money in their checking account and the explanation of benefits they get from the insurance carriers. They rip open envelopes and tear off checks. If there is no check some only wonder what happened. They often do not understand the reason codes and have no idea why there isn’t a check attached. While we may be resubmitting a claim with a corrected diagnosis or ID#, one eob comes through as a denial before the second one comes through paid. Some doctors never notice that they were for the same claim. They only notice that one didn’t get paid.
To keep our providers updated of what we are doing, we send a simple fax or email when we complete the billing for the week letting them know what the issues were. It might read something like this.
Dorothy Winn—has incorrect ID# – do you have a copy of her ID card?
Melvin Black—appealed denial for timely filing with electronic reports
Mara Rosen—clearinghouse report states she no longer has that Blue Cross policy—so you have new info?
Much of the work you do is not just the data entry of the claims and payments but your providers may not have a clue as to the extent of this other work. If you are in the habit of letting the provider know, they will value you even more.
A lot of times billing services think that if they are not hearing from the provider then he/she must be happy. That is a really bad assumption. They may be thinking anything from “Wow my billing service is great!” to “Man, what are they doing over there? Sitting around playing solitaire?” If you want to be successful you really need to know what they are thinking. The best way is to ask. There is nothing wrong with getting in touch with a provider and saying “things appear to be going pretty smooth from our end. How do you feel they are going? Is there any areas you are concerned about?”
If they are worried about something they should tell you. Then you can either rectify it if it is something wrong, or clarify it if it’s a misunderstanding. Many billing services have lost clients based on lack of communication. It’s something that can be easily rectified.