Common Patient Registration Mistakes That Affect Claims Payments

Are patient registration mistakes costing your chiropractic office money? Here’s how to avoid unpaid claims.

Gathering basic patient information – like names, dates of birth and insurance policies – is standard operating procedure in every chiropractic office. In fact, the process is so automatic, your office personnel can probably repeat each step in their sleep.

That isn’t necessarily a good thing though, because when your patient registration process is so routine or even taken for granted, it’s easy to miss the details and make mistakes.

Inaccurate or incomplete patient registration has a domino effect that can wreak havoc on your bottom line.

Such claims are rejected, delayed or denied, and your pile of unpaid claims will only get higher while your collections shrink.  

You can avoid problems with claims payments by implementing a thorough patient registration process.

Common Patient Registration Mistakes

Whether your patients fill out a packet of forms prior to their first visit, or they input their information at a front desk kiosk, it’s important to make sure you’re asking for and receiving the right information at the beginning of the registration process.

In addition, that information must be accurately recorded in your billing software. Here are the most common patient registration mistakes.

1. Basic Demographics

Complete demographics you’ll need include personal information, as well as contact information. The payer often requires such information to exactly match the information they have on file for your patient.

For example, Medicare will reject a claim if:

• there is any variance in the patient’s name and spelling, compared to their own database.
• the generation is left off of the last name, like Sr., Jr., or III.
• the date of birth doesn’t match their files.
• the gender is misrecorded, either because it’s simply the wrong sex, or your diagnosis isn’t appropriate for the incorrect sex of the patient indicated on the claim.

2. Patient’s Address

Some payers will reject your claim if the patient’s address doesn’t match the address in their database. This is probably one of the most frustrating issues, because when patients move, they often notify their insurance provider but forget to notify each of their healthcare providers.

This problem can also occur because of data-entry errors in your billing system.

3. Responsible Party Information

Having accurate responsible party information, including patient’s guarantor and health insurance, is essential for getting your claims paid.

The same goes for having correct health insurance policy information recorded in your patient’s account, as this will eliminate unnecessary claims rejections due to the payer’s inability to identify your patient as a member.

When obtaining your patient’s health insurance information, remember to ask them about the policy holder because sometimes the patient is covered under their spouse’ or parent’s policy.

4. Invalid Policy Holder Information

While some payers may allow the claim as long as the patient’s information is correctly indicated, other payers will reject it due to invalid policy holder information.

For example, your claim might be rejected if the policy holder’s date of birth is incorrect or missing, even if the patient’s information is correct.

It’s also important to remember to ask if your patient has more than one policy, and if so, which is the primary payer, secondary payer, tertiary payer, etc.

The Final Steps to Successful Patient Registration

Once you have obtained the correct insurance and policy holder information, the final step is to verify eligibility and accurately record that information in your billing system.

Here are five crucial steps that will complete your patient registration process.

1. Be sure to include the patient’s policy ID, group number (if applicable), policyholder information, and policy effective date.

    

2. After collecting this information from the patient, verify that the policy is active and that the patient is covered for your services.

    

3. Once you know the patient is covered, add the insurance information to your billing system, making sure to select the correct payer.

    

4. Because some payers have multiple addresses for sending claims, be sure to choose the one indicated on the patient’s insurance card.

    

5. Gather information needed for billing claims regarding the reason for treatment. This can include when symptoms began, and if there was a specific event or condition that caused the need for treatment.

If treatment is being sought due to an accident or injury, there are a number of 

additional factors that need to be clarified, including:

• the date of injury and whether the injury is related to employment, an auto accident, or other type accident.
• if the employer is responsible for payment, or if their workers compensation carrier is paying for treatment of the injured worker (if the injury is work-related).
• if a workers compensation claim has already been established, and if so, what is the claim number, the claims adjuster’s contact information, and where claims should be sent.  

All of this information should be collected and verified during registration, and added to the patient’s case information within their account.

If your practice is suffering from patient registration mistakes and unpaid claims due to a complicated or incomplete process, consider implementing solutions that can eliminate such mistakes.

These include easy-to-use patient kiosks, expert billing services, and certified EHR and Practice Management chiropractic software.

Don’t know where to start?

Give our team at ACOM Health a call at (866) 286-5315 – we’ll be happy to help.