Nuts and Bolts: How to Maximize Insurance Reimbursements

AdminWolf

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In this highly practical ODwire.org Webinar, Shane Shepherd, Senior Insurance Manager at VisionWeb, will help your practice maximize on claim reimbursements.

We'll learn to:
  • Find and understand your claim denials
  • Understand the TOP REASONS that claims are denied
  • Avoid the obstacles and seeing the benefits of pulling patient benefits ahead of every appointment
  • Analyze important reporting metrics that will help you better understand your entire claims process
 

AdminWolf

Site Administrator & Tech Lead
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My staff is registered but I get the watch right?
@AdminWolf do we just log on from here at that time?
If you register yourself as well (with your e-mail address) the system will shoot you a reminder before the show starts.

Otherwise, we'll keep the links up here the night of the show.

Should be a fun one, the "money" topics always bring out good Q&A!
 
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AdminWolf

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I thought it was very nice. Professional, smooth, but down-to-earth.
Thanks Jeff, and thanks for asking those questions -- always nice to get some good interaction going!

If anyone would like to continue asking questions, please do so in this thread, we'll make sure the conversation continues!
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Jeff Kiener

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Here were some notes I took:

1. Check benefits before patient arrives. He seemed to imply that a single clearinghouse can be used to investigate benefits, instead of going to each insurer's website (Availity, CheckMedicare.com, Navinet, UHC/Optum). Can anyone verify that?

2. There is a mechanism whereby some practice management software systems will be able to interface with the clearinghouse in such a way that electronic remittance advice will be downloaded into your accounts receivable and ledger the payment/write off/balance due. That is news to me, if I had that right.

3. The term "revenue cycle management"
 
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Larry Greidinger

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3. The term "revenue cycle management"

I had to look that one up after last night.....

Revenue cycle management (RCM) is the financial process, utilizing medical billing software, that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance.
 

AdminWolf

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I should have the webinar up in a little bit, hang tight....
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anup panjwani

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1. Can Shane tell us what procedures we use fall under what section.

I think he said pach is under radiology etc etc.

2. Besides Aetna and uhc, any other plans that may have the copay not assessed when physician charge is not present? And what is the wording we see in benefit eligibility lookup?

3. What service does he reccomend as best to get all the benefit information for major medical instead of each payers site? Availity or something else etc etc
 

anup panjwani

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1. If we see a pt say for a glc work up and they need a referral. We always require an online referral or refuse to see them. If the pt presents with a handwritten referral from the pcp or they are in office and we have to get a faxed referral, how do we submit that documentation with an eclaim to get the claim paid vs denied for no prior referral?
 

anup panjwani

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For what I understand, Medicare recognizes optometry as physicians and so we can not be discriminated on payments or access to Medicare panels. Is the same true for state Medicaid and the mco that run most state Medicaid plans? It seems these plans really kill the OD fee schedule and some do not allow access at all? Any federal laws you or gill Weber know of. Or state laws for say Maryland?
 
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anup panjwani

Active Member
May 21, 2011
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Great webinar by the way. A follow up on checking benefits would be awesome!

Things like this make me remember, I need to renew my supporting member dues, and this is not just the argue about trump and guns forum :)
 
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