Learn how a proactive approach and the right patient engagement can lead to coordination of benefits success.
How can hospital revenue cycle leaders improve COB denial performance?
Matt Fisher: “One of the things that we’ve found successful is to really engage our patients in the denial prevention process. The patient has a lot of ownership in helping us resolve denials when it comes to coordination of benefits denials, non-covered charges, coverage issues resulting in denial for expenses incurred before coverage termination, etc. There is a lot of patient ownership in there. And the more that you can involve the patient and work with the patient from an educational perspective, we’ve found success in that. I intentionally say “educational perspective,” because a lot of these patients have no idea how they can impact a denial simply by staying involved and stepping in where we need them to step in.
“Specifically in the coordination of benefits space, we find that a lot of patients will just flat out ignore the coordination of benefits letters that we send out. And they ignore the COB letters that are sent to them from their own payers. They don't fill them out. So sometimes a simple signature on that COB letter during service is allowing us, as the hospital, to get paid. It also helps the patient, because then it doesn't have to be where the hospital is chasing them down afterward or worse, flipping the balance to the patient where ultimately it may end up in collections for something that a simple signature from them could have taken care of.
“We've worked with some of our payers to obtain the coordination of benefits letters, and we have the patient sign those at admission. So just in case we get a coordination benefits denial, we already have the signed letter for us to turn right around and send to the payer at that point.”
