• Practice Solutions

Get Paid with Accurate Patient Records!


Main Points

  • Collecting all the information you need from your patients will help you to keep accurate records and collect from them what you need to

  • Patient demographic information is the first step to successful reimbursement

  • Patient demographic information is important to ensure compliance in the revenue cycle process

Getting a new patient inquiry is very exciting! A new patient inquiry is evidence that your marketing efforts are working and now you have an opportunity to use the skills that you have honed over time in the form of patient treatment.

But there is an important next step in developing consistent processes that help enable the treatment process, and that is capturing all the necessary patient information so you can get paid for services.

This step can be executed in many ways and many practice management software tools make this process automated, but ultimately it is your responsibility to ensure that you are capturing all the information you need to get paid.

Collecting all the information you need from your patients will help you to keep accurate records and collect from them what you need to is the first step in the process.

So, what is the information that you will need to start this process?

  • First name

  • Middle name

  • Last name

  • Date of birth

  • Street address

  • City

  • State

  • Zip Code

  • Home phone, mobile phone

  • Email address

  • Gender

  • Sex

  • Employment status

  • Insurance carrier

  • Insurance plan

  • Insurance ID number

  • Policy number

  • Insured party's information (i.e. spouse, parent, self etc.)

  • Any secondary insurance information

This information is critical to the success of your private practice because it will ensure that you send statements to the proper location and that you are billing the insurance company with the correct information.

Remember, the demographic information that you collect will be the information that is submitted on a claim or a superbill, and claims can be denied or rejected on the basis of this information.

Make sure that when you collect this information that it is legible and easily understood.

One reason that claims deny because of this information is that it is not the same as when the patient registered for their insurance. So, making sure that your patient understands this is important when managing their expectations

Patient demographic information is the first step to successful reimbursement. Like we said above, without accurate patient demographic information, your claims won't get paid.

For example, if the patient's zip code is wrong by even a digit, your claims will get denied.

The denial reason will come back with language around the patient information being incorrect or inconsistent with their coordination of benefits.

If you do receive this kind of denial, you should take the following actions to get paid:

  • Check online portals to verify the patient demographic information

  • Call the insurance company to verify the patient's benefits

  • Email the patient to inform them of the denial and ask them to follow up with their insurance

  • Resubmit a corrected claim with the correct information once you obtain the correct information

BUT, if the claim processes correctly, then the next step would be to submit a statement to the patient for the amount that the patient owes. This could be a copay, deductible, coinsurance, or the amount of the session based on their benefits.

However, if your patient demographic information is wrong then you will likely not be able to get the patient to pay on their amount. One of the best practices in the field is to keep a credit card on file, so you can always collect the patient amount.

Patient demographic information is important to ensure compliance in the revenue cycle process. The importance of getting accurate patient demographic information can hardly be overstated.

In order to make sure that you are operating a practice that is compliant you need to ensure that you are making a reasonable effort to get the best information that you can.

Patients ultimately suffer when providers or billers make errors when it comes to billing or collecting. If you don't document every detail from the correct address to the most accurate insurance information, claims can deny or reject, and then the patient is responsible for those charges and owes the practice.

However, if the practice fails to obtain the most accurate information or has loose processes around patient demographic information, the practice can lose money, time, or be seen as lazy in getting the most accurate information possible.

As a provider that runs a practice, it is important to be meticulous when it comes to capturing the most accurate information possible. If it sounds like a draining task to get the most accurate information possible, then you can always outsource the responsibility of entering patient information to a biller or to a virtual assistant.

However, if you are constrained by your budget, then contact your practice management software to see how they can assist in automating this process and get your patient information correct the first time!

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