Better not pout, I’m telling you why…and it is not that Santa Claus is coming to town, it’s that All Eyes are on You!

I received a telephone call this week from someone telling me that she submitted a claim to an insurance company for payment. The insurance company denied the claim because no prior authorization was obtained prior to the date of service. She stated that she did verify insurance…AFTER DELIVERY, because the Practitioner delivered the device WITHOUT going thru the Insurance Department for Proper Patient Processing first…Ugh!

Although the claim was under $500, and no Prior Authorization was required, the claim was still denied because the Insurance Company documented the Insurance Verification telephone call with the date and time. Now the appeals process has got to begin, causing a lengthy delay in payment, when it should have been paid the first time!

Better watch out…not going thru the Proper Patient Processing Procedures can come back to hurt your checkbook! Insurance Companies will do anything possible to hold up claims for payment, so Protect your Practice…go thru all the Proper Patient Processing Procedures BEFORE you ever provide services to your patient. Don’t get caught in a trap!

Have a great weekend everyone! Stay Safe & Warm this Holiday Season.