Often Doctors and managers ask: “What is the best single Tip to increase profit and patient care”. Obviously this depends entirely on the practice and the processes currently in use. Often, the doctor is looking for a specific code, fee, or piece of ancillary testing equipment that can be financially beneficial to the practice. The #1 change for a practice to increase profit and patient care it would be this: Make certain the doctor has both the vision and more importantly, the medical insurance benefits clearly presented prior to seeing the patient.
This requires the staff to ask for, obtain and document all insurance information at the time the appointment is scheduled. It requires the staff member to call the patient’s insurance company and ask the proper questions. Most importantly it requires this information to be effectively communicated to the doctor in an easily accessed form so the doctor will know exactly what the patient’s copay is and whether medical insurance will pay for additional testing. If the doctor doesn’t have the benefit information few other tips to maximize income will help. For instances, ICD-9 224.6 is a payable code for CPT 92250, but it won’t do any good unless the doctor knows what the patient’s insurance will pay and what the patient’s liability is. Remember it’s extremely important to gather the medical and vision insurance benefits and convey clearly to the doctor.
This insurance tip is provided by Shane Shepherd, principal in Practice Management Services, Inc.