65 is a milestone year for Americans.  Among other things, it is when we are eligible for Medicare.  When the government gets involved in anything, everyone needs to pay attention.  Taking proactive steps before your patients turn 65 will save you a lot of headaches and reimbursement problems.  Rock-Pond Reports provides a simple report that will keep you on track.  Here is how it all happened:

Rock-Pond received a call from a customer whose billing department began receiving denials for claims for long term patients whose claims were consistently paid on time.  After research they determined that the sole cause of the problem was the patient turned 65 and Medicare becoming their primary insurance.

After researching denied insurance claims they realized they were related to Medicare paperwork not being completed; even the patient was not 100% sure what to do.  Past due accounts mounted and cash goals were at risk because of insurance denials that were queued to be called on.  Although simple to prevent with advance notice, by the time the denials started coming in, many incorrect claims were in process and the provider was in a vicious circle of denials, past due accounts, phone calls, insurance verification and re-billing.  If they had known ahead of time when their patients were turning 65 all of this could have been prevented.  This is why they called Rock-Pond Solutions.

Rock-Pond Solutions created a simple report that included Name, DOB, Gender, Phone, Status and current insurance provider to identify patients turning 65 within the following 60 days.

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They now run this report each month to eliminate the guess work or individual searches to determine Medicare eligibility based on age. By using this report they were now able to proactively address the “age 65” issue before the first claim went out and save hours of work and headaches caused from unexpected denials, collection calls and re-billing.  Cash flow is up, employees are more efficient and patients are more satisfied.  The provider submits each claim confident that they will not get blindsided by a patient turning 65 without them knowing it.

Thanks to this provider, all Rock-Pond Reports customers are able to use this report as a part of their ongoing business processes.