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  • Emily Pasternak

Incomplete Claims & Patients

A common delay for claims this year has been missing patient information resulting in claims. This usually happens when the patient is seen, sometimes multiple times, without completing a Patient Registration Form or when newborns are not added to a policy or medicaid plan during the first 28-31 days following birth.

 

What this does.

When I receive a claim with missing patient information or patient nicknames, the claim is entered into CMD so that it can be tracked as an "Incomplete" claim. A biller will follow-up on the claim every week if the patient is only missing a medicaid ID# (pending a Medicaid application acceptance). Providers will be sent a report every month in the "Month in Review" email detailing what claims are outstanding as "Incomplete" and what information is missing.

 

How to avoid or fix the issue.

1. Always have patient's complete a PRF before or at the first appointment.

2. Review your monthly reports closely for any "Incomplete" claims and patients to gather their missing information at their next appointment or by contacting the patient/parent directly.

3. Logging in to CMD, incomplete claims will be listed on the dashboard. By visiting the patient's file, follow the screenshot indicators below to see where any patient notes will be kept by your biller as to the status of the patient's account.



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