UNDERSTANDING REVENUE RECOVERY First You Need to Determine Who Owes You Money and How Much Identify the Source of Payment: Insurer, Patient, or A Combination: Then the Next Step Is Billing Billers Are Not Collectors and Collectors Aren’t Billers
By Mark Christiansen Manager and Attorney for the Bureau of Medical Economics (BME) Many factors affect whether a physician is compensated for his/her professional services and the extent of that compensation. All physicians, at one time or another, have experienced the health insurer paying a check for remuneration for their services directly to the patient; sending a check for a reduced amount rather than what was billed; or a complete denial of the claim with no payment whatsoever. Most physicians are too busy healing patients to become actively involved in the remuneration stage of the process, so they 12 | THE BULLETIN | MARCH / APRIL 2015
don’t take the time to assess each aspect of their office’s revenue recovery procedures. This is a big mistake. Any time taken to evaluate your revenue recovery line of action is time well spent. Everyone is interested in decreasing the amount of write-offs; but there is something equally important in this day and age; personal accountability and its affect on the costs of health care. When an insurer does not pay the proper rates for services or a patient is not paying his/her patient responsibility there is no personal ac-