Minimize Claims Issues with One Simple Step Print
Written by M. Alexandra Johnson, FACHE and Wilma N. Torres, CPC   
Sunday, 28 October 2012 00:00

Most physician practices experience claims challenges, from denials and rejections to payment inaccuracies.  As frustrating (and costly) as those issues are, they are almost avoidable with one simple step:  verifying patient insurance eligibility.

For patients covered by Medicare, it may seem like a waste of time to verify insurance after the initial visit.  However, how can you be sure the patient did not knowingly or erroneously enroll in a Medicare HMO with which you are not contracted?  You would continue to see the patient and find out only when your claims are rejected that you, basically, volunteered your services with this patient.   

For patients covered by Medicaid, eligibility can vary, so it's crucial to verify that the patient is still enrolled in the Medicaid system for every visit.

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About the authors: M. Alexandra Johnson, FACHE and Wilma N. Torres, CPC are principals at Coleman Consulting Group. The firm's services include:

· Risk Adjusted Reimbursement (MRA)
· Coding & Billing
· ICD-10-CM Consulting & Training
· EMR/Meaningful Use Attestation
· Credentialing & Contracting

For additional information about the firm or to request a complimentary no-obligation consultation, please call 954.578.3331 or email

Last Updated on Monday, 29 October 2012 09:26