When it comes to filing claims, the clock starts ticking on the date of service, and everyone wants to move their claims smoothly through the revenue cycle on the first try. Unfortunately, that doesn’t always happen. And for any claim that requires extra attention, be diligent in your follow-up.
It’s often difficult to get payers to respond to your requests on more challenging, time-crunched claims. Emails and phone calls may go unanswered, unless of course it’s to inform you that the claim was conveniently received after the filing time limit.
If you’re dealing with a denial or rejection, analyze it carefully for the following:
Now, for the times when you have to make a second call (it should never take more than that) and are still feeling ignored, call and ask for a supervisor. If the receptionist answers, tell her no one ever calls you back—definitely don’t hang up if you’re left with the same answer as before. If you have to leave a message, put it in the general mailbox and let them know you’re getting the runaround; it’s best not to use a particular person’s voicemail because they will be the only one to hear it.
Here are some effective options for that second follow-up call:
But the most important thing to remember when dealing with payers is that your claims are important to the facility’s financial success. So if their inefficiency is impeding your payments, being a squeaky wheel isn’t the worst thing in the world.