Team HIC Blog

Written by Valerie Blackmon Wednesday, 23 February 2011 00:00

Are you a new office manager for a physicians or providers office?

One quick way to see if the physicians or eligible providers in your practice are participating with an insurance carrier is to go onto their website and do a search for all the physicians in your practice. Once you locate him or her, print out the listing for each provider so you can verify the information as of that date.

This is important for several reasons:

• It gives you a quick way to make sure all of your eligible physicians in the practice are credentialed for that insurance and you have a participating agreement with that carrier.

• It alerts you to verify the payments you are receiving are appropriate.

• It also is a way to verify that patients are viewing the correct contact information for your practice.  (It’s also free marketing so take advantage of it.)

Items you should be checking at least once a year are:

The spelling of all your physicians name & if you have a group contract with the carrier that your physicians are listed with the correct practice name.

This is important because if the practice changed names or added physicians and the file is not updated with the current information this is an indication that there might be some old out dated information in that insurance carriers files which might be impacting reimbursement.

You should also verify that the carrier has all the correct office location & phone number information in their database.

I can’t tell you how many times over the years that I myself have tried to contact a physician’s office from the phone number in an insurance carriers database or web page and found that the area code is incorrect or a number is transposed.

If the carrier lists any hospital affiliations in the database, you should verify that they have correct information as patients will sometimes eliminate seeing a specialist or selecting a primary physician depending on the hospital they are associated with.

You should check to make sure they have your correct specialty.

Sometimes if the credentialing was done prior to your becoming office manager, the physician or groups specialty might be reflected incorrectly.  That’s something that will require additional support documentation to be sent to the carrier to verify any specialty change.

Last but certainly not least is you should make sure you have a logon to their webpage to take advantage of any online processes available to you like:

• Making minor demographic changes to your files

• Requesting a sample fee schedule for your practice

• Policies & Procedures available for you to print or download.

• Helpful tools for you staff.

You can find a wealth of helpful information in the physician or provider related pages of their webpage’s. It really is worth scanning through every so often. You might be surprised what you find.