4.1D

Name
Course
Instructor
Date
Tracking Claims
Why is it important for Anne to track insurance claims processed through the clinic?
It is essential for Anne to follow-up insurance claims that are prepared via the clinic so as to identify those claims that are supposed to be followed up. Anne will also analyze the claims to check whether there are those that have not been paid for. Upon identification, Anne will be mandated to find out the reasons behind the payment shortfalls. All in all, insurance claims have to be followed up so as to ensure that insurance companies make the required deposits for their clients. What AR report should Anne use to identify the claims that require follow-up? What should she look for on this report?
Anne should use the accounts receivable (AR) Aging report to track the insurance claims (Writers). The AR report would enable her to look at the number of days that have been paid and those that have not been paid. This report also provides essential information on potential issues from a high-end view, as well as where such issues might be coming from. She should also look at the Insurance Payment Trend Report to check the amounts that have been billed out the actual amount that has been collected. She can then measure these figures against what is permissible with the insurance. Likewise, she should also check the insurance collection report to gain information on the claims that have not been sourced for a given period. Finally, she should also look at the clients’ visit status with regards to those claims that are in progress, batched, sent, filed, approved, approved failed, collections, and file rejected.

Anne finds five claims that have not been paid in the past three months. What should she do to obtain payment?
Anne can send the patient follow-up bills, contact the patient directly, or in certain cases use the services of a collection agency. It is important to note that different insurance providers have different rules and regulations that are used during bill collections, payment, and notifications, which is why it is important for Anne to go through these set standards before activating any of these measures (Writers). Patients are also supposed to know the medical unit policy with respect to financial issues. They should be well aware of all the options available in the case of payment shortfalls. In short, mutual understanding between the patient and the hospital about financial arrangements lessens the challenges of unpaid claims collection.
Work Cited
Writers, Staff. “The Medical Insurance Claims Process.” MedicalBillingAndCoding.org, MedicalBillingAndCoding.org, www.medicalbillingandcoding.org/insurance-claims-process/.