General Category > General Questions

Collecting EOB's and payments from your clients

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Michele:
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

Pay_My_Claims:
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:
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?? 

Michele:
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

PMRNC:
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

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