“Knowledge of the fee schedules … allows staff to ensure proper collection of payment at the time of service,” she wrote. She said this is especially important as high-deductible plans become more popular and patients increasingly compare costs for healthcare services. She said that patients desire transparency and will rely on the physician office or insurance carrier to disclose such information.
She said offices should also understand timely billing and payment guidelines, which procedures require prior authorizaiton or pre-certification, and which procedures are medically necessary. She said many payors set the base for their own fee schedule, so requesting fee schedule information is essential to adjusting claim payments when they come to the office.
