Collecting Revenue from Eligibility

Collecting revenue is essential for every active business. It is especially so for the medical profession, which works smoothly because of the use of expensive diagnostic equipment and highly educated staff that demand good salaries. It is not anticipated that indigent patients will ever pay their hospital bills, which only leaves a finance department that collects with efficiency all the monies due the hospital from all the available resources.

Eligibility resources, Medicare, Medicaid and Social Security Disability Insurance (SSDI) are examples of the most untapped resources. The more complex the claim is the less likely finance staff will be adept at collecting the money. If your staff is educated to submit the proper paper work right the first time, the wait time to receive payment is significantly reduced.

Not only should claims be submitted when a patient is discharged, there should be a look-back period after indigent patients are discharged. Upon admission, an indigent patient may not be eligible for Medicaid, but his status may change. When it changes, the hospital may still be able to receive payment for previous services. Medicaid approvals can be backdated in some states, allowing the medical facilities to submit claims for payment.

Training your finance staff to process eligibility paperwork more efficiently will increase revenue greatly. Fortunately, there are numerous companies that have the expertise to ensure your staff understands and masters the nuances of submitting Medicaid and SSDI claims.