Practice Resources & FAQS
New Patient Set up
What information is needed to set up a new patient for billing?
A complete new patient setup includes patient demographics, insurance information, subscriber details, provider information, diagnosis, service details, and any required authorization information.
Accurate information at the start helps prevent claim delays, rejections, and denials.
Verification
Why is insurance verification important?
Insurance verification helps confirm whether a patient’s coverage is active and whether services may be subject to copays, deductibles, coinsurance, authorizations, or other payer requirements.
Verifying benefits before services are provided can help reduce claim denials, improve patient communication, and prevent unexpected billing issues later.
Rejections/Denials
What causes claims to be rejected or denied?
Claims may be rejected or denied for many reasons, including incorrect patient information, inactive insurance coverage, missing subscriber details, invalid member IDs, incorrect CPT or diagnosis codes, missing authorizations, credentialing issues, or payer-specific billing requirements. Strong front-end processes help reduce avoidable claim issues.
Subscribers D.O.B.
Why is the subscriber’s date of birth required?
When the patient is not the policyholder, insurance companies often require the subscriber’s full date of birth to verify coverage and process claims. If the subscriber’s information is missing or incorrect, eligibility verification and claim submission may be delayed.
Preventing Delays
How can a practice help prevent billing delays?
Practices can help prevent billing delays by providing complete documentation, updating insurance changes promptly, collecting accurate patient demographics, communicating authorization requirements, and responding quickly when additional information is needed. The more complete the information is at the beginning, the smoother the billing process becomes.
Improving Revenue Cycle Habits
What are good revenue cycle habits for small practices?
Successful revenue cycle management depends on consistent habits, including:
-Collecting complete patient and insurance information
-Verifying eligibility before visits
-Confirming authorization requirements
-Submitting claims promptly
-Reviewing rejections and denials quickly
-Following up on unpaid claims
-Monitoring accounts receivable
-Reviewing reports regularly
-Small, consistent habits can make a significant difference in cash flow and practice stability.
Let’s Grow Together
We’d love to learn more about your practice and how we can help you thrive. Reach out today to get started.