Knowing Your Insurance Allowables

Building, updating, and maintaining your contracted allowables for the major insurance carriers you are contracted with is a crucial aspect of managing a well-run practice.  Having this data on hand and available for your staff:

  • Ensures you’re being paid at your contracted rates.
  • Informs your staff on the correct patient deductible and co-insurance amounts.
  • Reduces the number of patient statements being sent out because you’re collecting at the time of service.

This is much easier said than done, however.  Many practices don’t know what their allowed amounts are or how to access them from the various insurance carriers with which they’re contracted, and don’t have the extra staff time to do the research to track down the amounts.  This is costly to you as collecting from your patients AFTER the time of service can be a difficult and frustrating proposition at best!  By knowing what your contracted rates are, you can be collecting this money before a single statement is sent out.

PMRG has now worked with a couple of our clients to build and maintain an online spreadsheet with the allowables for major carriers and major procedures.  If this is something you’d be interested in having us do for you, please get to us.  In our experience, it pays for itself very quickly.

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