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Accurate edits return $$$

Patient Financial Services Weekly Advisor, March 27, 2009

By Vince Arencibia and Julie Souder

Many companies offer various services and ideas on how to improve revenue. Most, if not all, concentrate their efforts on the front-end registration process, dealing with eligibility, making sure the patients have enough insurance coverage, collection of co-pays, etc. All these procedures are important, good practices to follow and are essential to a good revenue cycle program.

One vital step in the revenue cycle program tends to be ignored or is inadequate – proper setup and use of a scrubbing system. In order to have a clean claim, there are a few components dealing with systems and personnel that need to exist. A good, reliable scrubber system needs to be in place, the billers need to know how to use it, understand the information the scrubber provides, and, most of all, know how to resolve claims issues presented by the scrubber.

Companies spend hours on research and development concentrating on how well the electronic file is built so the insurance company will accept it. However, even though it is an important step as part of claim submission, how accurate is the information within the file? What if you do not have electronic file submission established for all the carriers, and paper claim submissions need to a review?

Editor’s note: To read the full story, go to the Patient Access Resource Center.

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