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    • 23
      Apr
    • (0)
    • By PeteCrutchley


    • Medical Billing News

    How do you identify a patient excess?

    Many private consultant surgeons do not appreciate remittances sent to them are important.

    They are not just for tax reasons. They are not just to keep the accountant happy. There is time critical reason too.

    What does a remittance advice do?

    A remittance advice confirms the values that have been paid in respect of invoices submitted. It is a mistake to assume that the invoice will be paid completely. It may not be.

    For example and taking one remittance received by at MHM.

    Of the ten invoices paid on the remittance, four of them had deductions. Deductions were made against the value of the invoice originally submitted. 40% in other words.

    This is why remittances should be checked.

    How can checking a remittance advice help?

    In the above example, each invoice detailed on the remittance was reconciled against the appropriate entry on the debtor’s ledger.  It was then the number of deductions was immediately identified. In this example, the total came to some £350.

    The next step is to identify why the deductions have been made.

    All four deductions were correct and they were in respect of excess amounts.

    Mistakes happen.

    In the recent past, one MHM client had an invoice for surgery deducted because the patient’s policy had expired.  At least according to the patient’s insurance company it had but it had done so after the date of the surgery.  In this case, at the precise date of the surgery, the policy was “live”.

    The insurance company was wrong to decline the invoice.

    A call to the insurance company concerned identified and confirmed the error and the invoice was paid. Insurance companies do make mistakes. Not many but they do happen.

    If the deduction is correct, however, then immediate action should be taken. The patient should be contacted and a request made for payment must be made.

    The number and reasons why deductions have been made can easily be identified.

    That’s why you need to check remittance advice.

    pete@medicalhealthcaremanagement.co.uk

     

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