Create a Billing Statement in Excel for Insurance Industry with Ease

Billing statement in excel for Insurance Industry

hi everybody Jennifer blevin Smith with integral Clinic Solutions and you're watching my YouTube channel navigating the business of Medicine [Music] today I want to talk about reconciling insurance payments this is a workflow that I feel gets often overlooked and it is because it can be quite an undertaking to fulfill this task regularly but it is super important and I have found many private practices that this workflow and best practice is not adopted at all and so what I'm talking about is when you have signed up for electronic remains eras and so those are the paper eobs but in electronic form that come to you from the insurances for every claim that you submit it breaks down each CPT code and how it was paid what was contractually adjusted if it was denied it gives you all of that information it's a very detailed line item information that you need you take those and you post it to your claim in whatever system you're using to bill so you go and you find and you post each line item okay or it can Auto post for you a lot of you know with technology it will auto post and it will tell you what they paid towards those services so it will say Insurance paid total amount today is however much and if there's any patient responsibility what that is and it will tell you why and it will tell you and it will break it down itemized wise so each CPT code if their patient was responsible for a certain amount it will tell you if it went to their deductible if it was a copay or co-insurance okay so that's all taken care of but the Step that people are missing is actually making sure that the money that the insurance tells you they're going to pay you for those claims is actually going into your bank account and is accounted for and you also want to make sure the money that's in your bank account is getting posted right so it's a two-way street because of the electronic funds transfer that people often sign up for because it's less hassle of paper checks and having to scan them in and go to the bank and have it deposited just having ACH transfers electronic fund transfers it just makes it so much easier right but the thing is is you have to make sure that everything is reconciling so you need to make sure the money you're receiving is getting posted and the stuff you're posting the money is getting received and this is where people either forget about it they don't quite understand it or they don't realize they need to do it oftentimes billing companies if you hire a third party don't do this for you either this is definitely more of an internal type workflow that you need to implement because someone has to have access to the bank account or the deposit box the electronic deposit box lock box if you will where the money is going to be deposited from the insurance company and it can be really difficult sometimes to track those payments because the way they're labeled when they come through as an hch transfer sometimes it's not as obvious as you know like just straight up saying Providence or Blue Cross Blue Shield it might say something odd that you're not quite sure so it takes some investigating sometimes it takes some research to find out okay oh this one oh this is Tricare it says Department of Treasury or U.S Department of Treasury oh this must be a Tricare payment okay that makes sense and you kind of make a mental note or you keep like me it would keep a log of which names uh deposit names each of your payers have so that if you have a question about it or if it's one that you don't get paid from a lot you can go back and reference it and you need to make sure that you can run the correct report out of your billing system in order to see what was posted as payments so that you can compare that to what was deposited so the person doing this needs to have access to the bank account or the lock box where the funds are deposited and they also need to understand and be able to run that report out of your Billing System of what was posted to make sure they can reconcile everything and this like I said can be very time consuming especially depending on the volume in which you see patients and that claims come through and it's not an automated thing it's definitely a manual process the more you do it the faster people get but there might be an erroneous amount that needs to be looked into further or there might be a posting that you can't find the deposit and you also need to learn kind of the timing in between things so oftentimes people will get the era a few days before the money gets deposited or vice versa you find those nuances as you do this based on your Pairs and you kind of make a note of that as well so that if you get an era for Blue Cross Blue Shield and let's say a week later you still haven't received the funds and you know it usually takes two to three business days and that's way past that then you need to start making phone calls and I'm going to tell you right now in my experience there have been times I have found where something was posted because we received that they were going to pay for something and we didn't get the money from the insurance and you know weird things can happen right like a deposit might be rejected for some goofy reason or maybe there was a glitch in the system that it didn't go through I mean it doesn't mean that it's all reasons that are negligent it doesn't mean that it's you know any ill intent behind it but things happen especially when you're relying on technology we all know this so you know to be a good business person and a successful practice to be able to make sure that you're getting the funds that you deserve and that should be coming into you you should be adopting this and if you haven't already you need to do so very soon and I don't know if accountants would do that for you they'd probably charge you quite a large amount to do it because of it being so time consuming but I'm sure they would but I would if I were you and in my suggestion find the office manager or the billing manager or someone that you trust to be able to oversee this and do it for you because you as the provider or the owner you're not going to have time to do it but it's very important and this is something that is a high priority list item like it should be done in my opinion every day or every other day at the very most like it should not go longer than that because it just compounds more and more and then you have more and more that you're going to be chasing down if you have any issues so it should be done regularly and hopefully you have someone in place that's already implemented this for you but you also need to make sure you're following up with them so don't just take for granted that it's all getting done and it's getting done correctly you need to be checking in with the person that's doing this just like I had mentioned you have regular meetings with your billing person to go over denials and anything that you're seeing reduced reimbursement or any kind of issues like that it's the same thing you should be meeting with whomever is responsible for this and ask them to see the logs for the reconciliation to see and ask them if there's any issues or trends that they're finding that are things that they're having to hunt down from payers or contact payers um you know so that it doesn't broadside you at the end of the year when you're still missing fifty thousand dollars that you should have been receiving from the insurance company that they've been trying to track down but they haven't or they waited too long to reconcile and they won't be able to reconcile by the end of the year to help you with your accounting and finances for end of year I mean there's so many things so you want to make sure that you're staying on top of that and there's a checks and balances system as well I would love to hear from you guys on your experience of doing this and how it has either benefited your practice if you've caught anything that maybe you wouldn't have if you didn't have this best practice workflow set in place and also who in your practice actually does this or people do this and and how it works so that it's not super time consuming for one person and it gets the job done and the goal is achieved every day smash the Thumbs Up Button if today's video was helpful subscribe to my channel if you haven't already thanks so much you guys I appreciate the support bye-bye [Music] foreign