You’ve streamlined everything in your urgent care business–optimized your marketing, integrated your EMR, and adopted telemedicine to ease staff burdens. But one thing can still bring your profits to a screaming halt–claim rejections.
Those claim rejections typically stem from small mistakes that have a significant impact–transposing two numbers in an address can lead to bills being sent to the wrong address, more work for staff as they try to reach out to patients, and delays in insurance payments. And those tiny errors are common. Solv surveyed our partners and found that 44% of patients enter an incorrect address, leading to chaos down the line.
But incorrect addresses aren’t the only issue. The registration process can be a minefield of misinformation when patients are in a hurry or absent-mindedness as they struggle with illness and seek care. Here are the top three areas where mistakes can be made.
Patient Demographics
Shakespeare may have wondered what was in a name, but any front desk manager knows–it matters. Many patients grow comfortable with using a nickname or don’t regularly use their full name, including any generational designations, like Junior, Senior, or III, but insurance companies need exact information. Encouraging patients to register the same way their name appears on their insurance policy is essential for claims to be processed accurately.
Using the correct full name has another impact–it cuts down on duplicate patient records. If you have several members of the same family as patients, keeping their files straight may come down to the birth date and their generational suffix.
Date of birth is another place patients can easily make a mistake, but typing the wrong day, month, or year can send a claim to the rejection pile. When common surnames or names from the same family but different generations are in play, date of birth may be an essential identifier to file claims correctly.
Patient Address
Address mistakes are one of the most common registration errors, and not just because of inattention or random mistakes at registration time. If a patient has moved since their last visit, they may have changed their address with their insurance policy. Because of the episodic nature of urgent care, many may not think to bring up a change of address when they come in for a sudden illness or accident.
When the address doesn’t match, either by a digit or a complete address, it can slow down the billing process as the address must be verified and checked. Not only does it cause more work for your staff, but it risks patient bills being sent to old addresses. With sensitive patient information, it’s in the patient’s best interest to keep any correspondence going to their eyes only.
Health Insurance
Since health insurance policies change so frequently, especially around the start of the year, verifying the responsible party holder is essential. If you’re billing last year’s health insurance plan for this January’s visit or assuming that the party holder is the same on the same plan, it can slow down the claims process significantly. If the insurance policyholder has changed from one spouse to the other, you must verify that to ensure an accurate claim.
Inaccurate policyholder information is another area that is susceptible to mistakes. If a parent brings in their child for a flu test, some insurance companies will approve a claim if the patient information is correct. Others will reject a claim if the policyholder’s information is incorrect, including date of birth, name, address, or other identifying information. Double-check the policyholder’s info, no matter who receives treatment.
Solv Solutions
In addition to leading to claim rejections, inaccurate registration information leads to more work for your staff. With attrition rates continuing to rise, eliminating duplicate work can help create better staff morale and save labor time and money.
Luckily, Solv has created a new premium feature designed to eliminate registration errors, improve address validation and eliminate duplicate patients. This new feature will save your staff time and frustration and keep your billing department moving forward, not backtracking to work on rejected claims. Are you ready to save time and take another burden off your staff? We’d love to help. Take a demo of Solv Revenue Maximizer today.
