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Tip: Make AOBs a part of your registration process

Patient Financial Services Weekly Advisor, October 22, 2004

The following tip was written by Gwen Parrish, CPAT, managed care coordinator, Southeastern Ohio Regional Medical Center in Cambridge:

Picture this: A patient presents to your ED after an auto accident. You bill his auto insurance company and the payment is sent to the patient. His health insurance will no longer consider this claim and you are left to explain to the patient why he owes your facility for the services.

Medicare requirements state that Medicare is the secondary payer when medical care is obtained due to an accident. Commercial insurance companies are rapidly adopting this position as well. Patients do not understand why their health insurance does not pay these claims, instead allowing the auto insurance to reimburse them.

Facilities can assist their patients and protect their interests by obtaining an Assignment of Benefits (AOB) specific to these situations.

When a patient presents for services due to an auto accident, the registration clerk should provide the patient with a form explaining the billing procedure, requesting auto insurance information, and providing a phone number for questions.

Staff should also give the patient an AOB specific to accidents. This form legally requires the payer to make payment directly to the facility or at least include the facility name on the payment.

We give a preaddressed, postage-paid envelope to patients who do not complete the forms during their visit. Registration staff provide the billing specialist assigned to these claims with the information obtained at registration, and communication with the patient can begin immediately if needed.

The process of obtaining a specific AOB has multiple benefits. Many people do not understand the "Med-Pay" benefits of their auto insurance and appreciate our efforts in educating them. The auto insurance company will pay medical bills as incurred up to the specified dollar limit of the policy.

This process has allowed our billing specialists to develop working relationships with many of the auto insurance companies. A copy of the AOB is submitted with the claim. The insurance companies respect the validity of our AOBs and pay our claims promptly.

The result has been an increase in patient satisfaction, reduction in follow-up required for this type of claim, and an increase in revenue. It is well worth the effort to make it part of your process.

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