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Importance of Getting All the Information from Clients Before Billing Midwives Insurance Claims

1/13/2023

 
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Billing plays a significant role in your practice’s revenue. When you have your patient, you either bill them out personally or through their health insurance coverage. Getting cash from clients may be easier but what if they will use their insurance? Not all insurance claims get approved, there are times that patients get rejected and as the healthcare provider, it will greatly affect you and your practice. Study shows that insurance claims can also be denied or rejected for a variety of reasons. Many of these denials are due to human error. 75% of claims were incorrectly coded.  To avoid this to happen, you must get all the information needed and verify it first hand before submitting claims. 
Insurance claim data entry is very challenging. It is common for insurance claim documents to be copied, shared, and reviewed by multiple departments depending on the type of claim. Multiple employees cannot work on the same claim simultaneously if they have to deal with physical documents. These steps can cause errors or omissions in claim management software by manually entering data from different documents in a claim. This could lead to chaos, delay payments, mishandling the claim, and/or create delays in payment.
It is vital to have a healthy revenue cycle to support the expensive work of every midwife. However, it can be difficult to ensure that your practice receives payment for the services it rendered. This can be especially difficult because midwives often get reimbursed by third party payers after the patient has left. There is also a delay between rendering services and receiving payment.  Below are the reasons why it is important to get all the information from clients with billing insurance claims out:
  • Privacy and Data Accountability – Protecting sensitive information of clients is crucial for insurance companies, particularly in this age of data protection. It is extremely important for insurance companies to make sure that their data is accurate, protected and organized. In fact, the threat of data theft and other malicious attacks revolves around lack of accuracy and clarity. As a maternity care provider, you must protect your patient’s data and by collecting and verifying thoroughly. 
  • Fraud Detection – Fraud costs the insurance industry billions of dollars each year. Fraudulent practices in insurance arise in many different forms. Insurance carriers can help combat fraud by ensuring that their records are up to date or accurate – both in its organization and its references. Reports from the Insurance Information Institute suggest that the US auto industry saved $128 million through detailed data checks like the photo inspection process. Data such as photo ID and basic cleansing can help reduce costs for insurance carriers across the country.
  • Better Customer Care – Accuracy in data is vital to ensure better customer service. The more accurate insurance data is, the more specific policies and pricing will be. For instance, insurance premiums can be complicated, particularly for the end-user or policyholder. Therefore, insurance companies need to ensure that their numbers are accurate. On the other hand, duplication in data is another factor that causes problems for insurance experts and policy holders. Failure to compile data in a specific place and into one singular, accurate record could lead to mispricing. Outdated records can also lead to inaccurate policies, quotes, and extra expenditure for customers.
  • Efficiency and Processing – Inaccurate records and poor data collation can lead to more time and effort used for putting together policies. While filing for claims, policyholders require quick action. If insurance carrier data is poorly organized or unclear, this could impact a company’s reputation as well as the customer experience. In addition, it could impact the quality of the end product for the policyholder. As the insurance industry revolves around data, inaccuracy in data may result in a policy that fails to protect a user in the way they expect. Therefore, it is important to make sure the data they work with is clean and easy to source.
Mos, & *, N. (2022, October 18). Importance of data accuracy in the insurance sector. Managed Outsource Solutions. Retrieved November 28, 2022, from https://www.managedoutsource.com/blog/why-is-data-accuracy-important-in-insurance-industry/

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