In a busy office, it’s inevitable that data entry mistakes are going to happen. Typos are going to happen. But every time a patient’s information gets entered incorrectly, it means the claim will reject or deny, and someone is going to have to do additional work to find the mistake. How do you keep this from happening? A few simple processes can help eliminate the majority of these errors!
First, at check-in always double check basic demographic information: Is the name spelled correctly? Is the address right? Do you have the correct date of birth? Next, ask for a copy of patients’ insurance cards, even if they say their insurance hasn’t changed, and always check that policy ID numbers are entered correctly into your system with alpha characters included but no spaces or dashes. Does the name match the card; is the spelling right? Is the relationship between the subscriber and patient correct? Always get both the patient’s medical and routine vision insurance information since you don’t know where the claim will be filed. Finally, scan the card into your system for future reference should the need arise.
Starting July 1, 2022, Aetna no longer requires precertification for cataract surgeries for any of their commercial or Medicare plans, with the exception of their Medicare Advantage plans in Georgia and Florida. This is great news for optometrists. Not only are preauthorizations costly and time-consuming for the office, but waiting on the approval causes unnecessary delays in patients’ access to care.
