Monday, September 16, 2024

Payment review

Jeremiah Uronis

Hi-

Has anyone gone through a payment review process where the insurance carrier freezes payment on everything? In this case its a Blue Cross type provider. They are requesting hardcopies of all submitted claims in addition to our electronic filing. A patient complained that we were being fraudulent (which we aren’t of course) so they came and pulled 40 charts and are making things unnecessarily painful. Everything is in order on our end but we are going through the old well you didn’t dot your “I” and cross you “T” game.

Some people in our office say it will just blow over and others are worried it will sink the ship. We would prefer to be proactive in this matter and help the carrier get it resolved as quickly as possible.

What is the best way to handle this? I was thinking we just be overly nice and attentive and push through this. We are a small operation and need to get paid sooner or later as this is a third of our business.

Thanks, Jeremy

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