HEI Knowledge Center: Pushing Payers to Pay Up
Hi, my name is Steven and I’m an Account Resolution Specialist for HEI.
Today I wanted to share a quick, best-practice tip for revenue cycle collectors, that is: Don’t settle for just status-ing claims, and remember to put pressure on the payer to pay the claims within a timely manner.
From time to time, we must call payers to check the status of a claim. If you find yourself calling a payer multiple times on a claim without any action being taken, that should be a red flag.
There are laws outlining the timeliness payers must stick to when we have submitted a clean claim. Get to know the laws that apply to your state or organization by going to the naic.org website and clicking on the state your provider is working in.
If necessary, ask for a supervisor and escalate the claim with them. If it is applicable in your state, be sure to remind them that they might need to pay interest if a claim takes longer than 30 days. Finally, if necessary, you can pressure insurances by telling that you’re going to file a complaint with the National Association of Insurance Commissioners.
So just remember that the more you push for insurances to process claims on time, the more often they will.
As a side note, if you are working out of CollectLogix and you check the box saying the claim has been with the payer for over 31 days, the applicable legal state law will be displayed for your reference on the call.
Thanks for watching, and I’ll catch you next time.