Author Topic: Collecting EOB's and payments from your clients  (Read 4166 times)

PTBILLER

  • Newbie
  • *
  • Posts: 35
  • Practice Management Solutions for Physical Therapy
    • Physical Therapy Billing Services
Collecting EOB's and payments from your clients
« on: April 10, 2009, 08:07:15 AM »
Good Morning and Happy Good Friday! 

I am having a problem with one of my clients and need to get some advice.  This provider is out of state so therefore, I can not offer to come in with ideas.  In working with these providers, they fax/email patient info and charges and mail copies of EOB's.  I receive the EOB's weekly and post accordingly.  Upon following up with insurance payors when not getting payment, I'm finding (like I said consistently) that I'm missing payments, EOB's, etc.  Of course, this is a HUGE waste of my time and money (as I have a person following up on old claims that I also have to pay).  At this point, I'm trying to be professional and am asking for the copies (I give them the check number, amount, date issued) and have also asked them to put together a plan of action in order to avoid this.  I really don't think that they are doing this intentionally to avoid paying me, but I think that they are extremely unorganized.  They are also from another country and therefore have a slight communication problem. 

One thing I was thinking is this:  I know that some billing services receive payment/EOB's at their offices and forward them (not sure how it works) to the providers.  Does anyone have ANY IDEAS that they can provide me with.  I hate to give them up.  I make decent money with them even though they are total screw ups!!! >:(  Any advice from you guys is truly appreciated!!!   Thanks
Pam McKewen

PTBILLER

  • Newbie
  • *
  • Posts: 35
  • Practice Management Solutions for Physical Therapy
    • Physical Therapy Billing Services
Re: Collecting EOB's and payments from your clients
« Reply #1 on: April 10, 2009, 08:09:51 AM »
OH-one  more question....if you do get EOB's and checks at your office, please let me know how this is performed. 
Pam McKewen

Pay_My_Claims

  • Guest
Re: Collecting EOB's and payments from your clients
« Reply #2 on: April 10, 2009, 11:38:20 AM »
Most insurance companies have resources for you to obtain the EOB's online.

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4710
    • Solutions Medical Billing
Re: Collecting EOB's and payments from your clients
« Reply #3 on: April 10, 2009, 12:47:33 PM »
We can SOOOOOOO relate to you.  We just had a discussion about this today.  We are going to add a section in our contract that states if they do not forward us xx% of eobs then we will have to charge addt % to make up for the unnecessary work/phone calls it causes.  We do have a couple of providers who have the payments sent to us and we forward them the checks.  One we insisted.  He lost his sister (unexpected death) and has not gotten himself together (3 yrs later) so we told him we had to have checks sent to us.  He was losing the checks, not cashing them.  It works fine.  I would suggest it to them and if they don't want to then explain that it is crucial for you to get ALL eobs in order for you to do a good job.

We have an envelope and we just stick all checks in labeled envelope and mail once a week.  Works good.

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

Pay_My_Claims

  • Guest
Re: Collecting EOB's and payments from your clients
« Reply #4 on: April 10, 2009, 09:16:39 PM »
i can understand where u are coming from, but i don't want to be in possession of any provider checks. also as far as the eob, providers can view that as double working himself. its one of the perks for having an in-house biller. working in house, i have seen eob come with the checks, and some don't. i have also seen payments made, but we never recieve it and have to track it down. its all a part of what we do as a biller. im not saying that providers should make it difficult, but i know how hard it is to convince a provider to even hire someone to do his/her billing outside of the office, and before i charge them for "not" sending the eob, i will be trying to find a way thats mutually beneficial for both of us

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4710
    • Solutions Medical Billing
Re: Collecting EOB's and payments from your clients
« Reply #5 on: April 10, 2009, 09:40:14 PM »
I know what you are saying, it's not always the providers fault.  That is why we say it's got to be over a certain %, where it is indicating it's a problem.  All of our providers have at least once not gotten us an eob, for whatever reason.

For us it's the habitual offenders.  For example, we have a provider that we have been meeting with for over 5 years.  Problem is the wife is the office manager and is afraid to let go of any billing, but Dr/husband is insisting.  So they turned over one major carrier to us.  So the only claims we do are to one carrier and it is a big one, and the eobs always accompany the check.  We did our follow up for them this month and ALL BUT ONE claim was paid to them, and the checks were cashed.  So every claim but one on our follow up report was actually paid and as I said it is a large local insurance carrier and the checks are always with the eobs.  This is a problem. 

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

Pay_My_Claims

  • Guest
Re: Collecting EOB's and payments from your clients
« Reply #6 on: April 11, 2009, 01:35:04 PM »
i totally understand. one of the battles of medical billers looking to have their own medical billing practice such as myself face is change. providers are used to having billers in house, and are reluctant to change. wifes are involved in the business, or in one of my cases husbands. people get into the business and think its easy, when its not. others make it harder for those that do have experience, but have created a bad taste in providers' mouth.

PTBILLER

  • Newbie
  • *
  • Posts: 35
  • Practice Management Solutions for Physical Therapy
    • Physical Therapy Billing Services
Re: Collecting EOB's and payments from your clients
« Reply #7 on: April 13, 2009, 07:59:26 AM »
Michelle-

I am definitely going to try to get these providers to get payments sent to me.  I would like to know what needs to be changed on the CMS-1500's.  Basically, what do I need to do in order to change address where checks and EOB's are sent?  I send all claims electronically if possible, but can still change to my company's address...would this be #33 on CMS 1500?? 
Pam McKewen

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4710
    • Solutions Medical Billing
Re: Collecting EOB's and payments from your clients
« Reply #8 on: April 13, 2009, 08:27:01 PM »
You can't just change the address on the form.  You have to contact each insurance carrier and do whatever is required to change the provider's correspondence/pay to address.  Once the address is updated with the carriers you just need to change the practice address to your address.  Whether you are billing electronically or printing, the info should be in the appropriate place. 

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

PMRNC

  • Hero Member
  • *****
  • Posts: 4218
    • One Stop Resources & Networking for Medical Billers
Re: Collecting EOB's and payments from your clients
« Reply #9 on: April 15, 2009, 08:11:38 AM »
I've always preferred educating the provider and sometimes that means hitting them in the wallet until they fully understand that they LOSE money when they don't send me the information I need.
Setting up with the carriers to send checks to you is a tedious and daunting task, not to mention a nightmare for the provider later if they should want to go in-house, etc. A lock box type setup might be more beneficial but still I prefer to educate the staff/provider on the proper way of information flow. I used to charge extra for any EOB's or payments I had to obtain due to them not forwarding the info to me. I did this when it was a repeat offense.

Linda Walker
PMRNC
www.billerswebsite.com
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4710
    • Solutions Medical Billing
Re: Collecting EOB's and payments from your clients
« Reply #10 on: April 15, 2009, 11:28:47 AM »
I agree with your Linda.  We don't prefer to get the checks but we have found a couple (3 to be exact) where it does work well.  One the provider insisted.  The other was a provider who takes 4 months off every year to go south.  That really messes up things because he has his mail forwarded and some carriers (Medicare) won't forward.  The last was the dr who lost his sister and doesn't have a receptionist.  He just couldn't pull himself together and was losing the checks, not cashing them, not giving them to us.  This went on for 18-24 months and we decided to switch it.  It has worked out great, but again, it is not what we prefer.  All 3 are providers we have worked with for a long time and the relationship is very good. 

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

PMRNC

  • Hero Member
  • *****
  • Posts: 4218
    • One Stop Resources & Networking for Medical Billers
Re: Collecting EOB's and payments from your clients
« Reply #11 on: April 16, 2009, 07:51:11 AM »
Of course there are situations where this works fine, but the root of the problem is easier to correct than work around. For example, I had a client who's billing company fired him primarily for this reason, they were frustrated. My job was to hire him additional staff and to get him back on his feet In house.. He was a mega control freak and was the one to collect and open all mail, that is how he wanted it and nothing was going to change his mind. I worked with the billing staff as much as possible to get him to turn over this task to the staff. Finally we had to take more drastic errors which resulted in him receiving inaccurate reports, patient phone calls (upset because their statements were not reflecting balances) I had the billing staff take messages or let them speak with the provider himself. Of course this overwhelmed him and we finally sat down to discuss how his "control" was causing his practice to lose money, frustrate and alienate his staff, not to mention what it was doing to the practice reporting. He truly just believed cashing/depositing his checks meant the job was done. We had to sit him down and go over the process and educate him on it. After some education on this he gave up that control and was much happier with his deposits all ready for the bank and the staff having the EOB's or check copies to post..    The other billing company had tired of the power struggle so putting a bandaid on the actual problem is never usually the right choice, certainly it's a last ditch effort. DOCTORS need to be responsible and they NEED to understand the flow. When I do large office staff training we do job flow studies where the physicians actually spend time in the billing department learning the process and this really goes a long way into educating them in the right way to do things.

Linda Walker
PMRNC
www.billerswebsite.com
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4710
    • Solutions Medical Billing
Re: Collecting EOB's and payments from your clients
« Reply #12 on: April 16, 2009, 11:38:35 AM »
I agree with you 100%.  I just wish that it were easier to 'teach' providers.  They are good at practicing medicine but many are not good at the paper end, cash flow, etc.  Sometimes I feel like I'm banging my head on a very thick cement wall!  All that gets me is a visit to the Dr.  :)

Michele
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

PMRNC

  • Hero Member
  • *****
  • Posts: 4218
    • One Stop Resources & Networking for Medical Billers
Re: Collecting EOB's and payments from your clients
« Reply #13 on: April 16, 2009, 04:37:16 PM »
I agree! the process can be very frustrating. MOST doctors when they are hit in the wallet learn quickly. I had one that was just plain "lazy" but when he seen that I was charging him for the FULL billed amount of the claim because he did not send me the EOB and when he took the patient's phone call when she got the bill for the balance, he quickly realized this wasn't going to work. I know this is awfully stereotypical to say, however doctors know two things: Medicine and Money <g>   ;D
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

PTBILLER

  • Newbie
  • *
  • Posts: 35
  • Practice Management Solutions for Physical Therapy
    • Physical Therapy Billing Services
Re: Collecting EOB's and payments from your clients
« Reply #14 on: April 19, 2009, 05:35:55 PM »
Hi-You both have helped a lot in this daunting task!  Over the weekend, I sat down and made a work flow sheet that they can actually not only try to follow but hopefully try to reorganize.  I hate thinking about getting the checks here.  Too much of a pain to switch and I really don't want to be held responsible for it.  It's funny because you had mentioned "the other billing service getting frustrating and firing the provider".  I think that's what happened in this case (although I'm sure the service didn't tell them that).  They told them that they were too busy...kind of a lame excuse, if I do say so myself! ;D  Anyhow, hoping to get them to realize their work flow needs help.  Thanks again.  (please feel free to input on my next question!)  I love this place!~
Pam McKewen