Payer Follow-Up Part One
This course identifies the reasonable time frame for payment and the tools available for accurate and timely follow-up on outstanding account balances.
- Define the term follow-up and when payment maybe expected.
- Specify who is responsible for an unpaid balance.
- Categorize reasons why follow-up is needed.
- Cite the three R’s of follow-up: review, research, and react.
- List the steps on the roadmap to follow-up what’s the patient type and service code, dates of service, insurance or payer codes, account notes, and charge and payment transactions.
- Name several resources to assist with follow-up from the hospital, the payer, and the Patient.
- Specify the payment documents that assist with follow-up.
- Distinguish between the HIPAA data standards ANSI 835 and 837.
- Select various follow-up techniques: online claims tracking, sending status bills, ATBs, telephone, and fax.
- Differentiate between non-paid claims, rejections, pends, and partial payments.
- Identify methods that credit balances may be followed up.
