Follow these steps:
- Get the prospective resident’s insurance information upon admission or, even better, prior to start of services.
- Call and verify that the insurance information you have on file is up-to-date and current. Talk through the benefits available and ask specifically about any co-pays or co-insurance that are due.
- Communicate with the resident up front what the estimated costs will be for services that your organization will be providing, and collaborate on an appropriate discharge plan that matches what the family can afford.
- When the explanation of benefits (EOB) is processed by your billing person, consider including a copy of the EOB with the statement so that the resident and/or family can clearly see what the extra charges reference.
- If you have accounts that are in default, be sure to have well-documented collection efforts so that you can include those default accounts on your Medicare cost report.
Questions about this topic or other reimbursement/payment issues or KanCare concerns? Contact LeadingAge Kansas’ Reimbursement Specialist Joshua Johnson.
