In: Operations Management
You just stepped into a new role as an office manager. Due to a lack of consistency throughout the office, you have been asked to update the billing policies and procedures to include the following elements: Step-by-step instructions for the entire revenue cycle from pre-verification of insurance to accounts receivable management. Methodology your office will use to determine a pricing structure. Considerations for negotiating insurance contracts. Considerations for private pay and charity care.
Scheduling
Collect correct information about the patient and exchange information regarding financial policies and payment options and what the program covergae would be.
Eligibility
Connect with the insurance provider to assess eligibility of the patient.
Reminder Call
Inform the patient 2 days in advance about their appointment and insurance eligibility.
Registration
Eligibility
Verifiing the insurance documents submitted to the hospital with the insurance provider and check eligibility of the patient. Also collect information regarding the actual amount the patient may end up paying.
Visit
Checkout
Claims Submission
Payment Posting
The hospital staff will display the payments or any denials.
Claims Follwup
Follow up any claims / Bills that are unpaid
Patient Billing