CLAIM FOLLOW-UP SCHEDULE
The following schedule is recommended for written and telephone follow-up for outstanding claims:
30 Days
Mail or fax a follow-up letter containing all relevant claim information (including original filing date) and a copy of the original claim. Request an explanation for payment delay and state that the original claim was filed in a timely fashion
with all necessary information contained on the claim form.
Indicate that the letter is a 30 day follow-up and additional follow-up will occur if payment is not received promptly.
60 Days
Send a similar letter and copy of original claim as before.
Indicate that the letter is a second, 60 day follow-up and additional follow-up will occur if payment is not received promptly.
90 Days
Begin telephone contact with the insurance carrier to determine the status of the outstanding claim(s).
Talk to a supervisor or someone with authority.
Note on the patient’s claim folder the contact date, the name of the person contacted, the claim number, and any relevant information needed by the carrier to process and pay the claim.
Take appropriate action to speed the carrier’s claims payment process.
If telephone contact is not possible, send another letter and claim as before. Indicate that the letter is a third, 90 day follow-up and additional follow-up will occur if payment is not received promptly.
120 Days
Telephone contact is essential. Contact the insurance carrier as noted above.
Stress that the claim is seriously past due and good faith efforts to secure payment have failed.
Take appropriate action to speed the carrier’s claims payment process.
180 Days
Contact the insurance carrier by phone to determine delay in payment.
At this point, all required information should have been sent to the carrier.
Again, stress the past due status of the claim, determine if additional information is required and take appropriate action to speed the carrier’s claims payment process.
Over 180 Days
Contact the carrier as often as possible, with no more than 30 days elapsing between communications.Concentrate efforts on resolving these claims.
Write-offs should only occur if the carrier has indicated refusal (for valid reasons only) to pay the claim.
Note : This Article is just give the basic idea and may not suitable for this electronic world. Now most of the insurance accepts claims by electronics and paid with in 30 days. Hence follow up after 45 days is best.
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