Keeping your Cash Flowing

Written by: Joanie Zavala on Monday, October 19, 2015 Posted in: Home Infusion

moneyAs discussed in a previous blog post, if your DSO climbs too high, this will negatively impact your company’s profitability, and you could end up with uncollectible debt. But there are steps you can take to collect cash more quickly and shorten turnaround times.

1. Know your payers: Maintain a complete understanding of your contracts, and determine what is covered, what is not covered and what, if anything, is patient responsibility.

2. Confirm deliveries: Maintain proof of delivery, and make sure you confirm delivery tickets in a timely manner.

3. Authorize: Determine whether or not an authorization is required up front, what the authorization covers and how long the authorization is valid. Re-authorizations at the appropriate time are equally important.

4. Collect patient portions: Collect as much self-pay money up front as you can.

5. Send electronically: Submit claims electronically whenever possible. This provides proof of claim submission. Whenever you speak with a payer and/or patient, etc. make sure you obtain their names or case numbers (anything that will identify the call was made), date, time and location of party(s), and note this in your system. Notes are the key to tasks performed and provide a solid history of action taken.

There are also many steps you can take to continually improve cash flow on an ongoing basis. These include:

1. Train your staff: Ensure that your staff is trained in home IV billing and collections. This includes education on new therapies and drugs and keeping your staff up-to-date on payer contracts.

2. Staff appropriately: Maintain sufficient staff to handle your business. All too often, billing is perceived as a “press of the button.” This could not be further from the truth. A great deal of time and effort must go into the overall reimbursement process to ensure success. There are too many details that, if skipped or overlooked, will result in denials, which only mean more work and putting your payments at risk.

3. Bill frequently: Deliveries are made daily, so billing should be done daily. Many payers will not allow you to send a claim until the end date of service on your claim, but others will allow it. Claims should be billed as quickly as the payer allows.

4. Follow up: Electronic claims have audit trails, but paper claims, which are often required, do not. You should confirm that paper claims are received and are in process within 14 days of submission. Follow up on all claims every 30 days, at a minimum. Payers are trained to delay, so don’t accept generic responses to reasons for payment delay.

5. Act quickly: If a claim is denied or only partially paid, it is imperative that you determine the cause, and appeal the decision as soon as possible. You should also determine if this is a one-time event or if it has impacted multiple claims. Take the action necessary.

If you need help with cash flow or are interested in having your processes evaluated or getting specific ideas for improvements and DSO reduction, contact Mediware Reimbursement Services here.

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