PracticeWorks: eClaims with dates of service in 2019 being converted into pre-authorizations

[paul_snyder]

Good Afternoon Carolyn,

The claims from 1/1 - 1/7 were all resubmitted on 1/8.  You received a transmission log report in your eServices report listing those claims.   Do you recall specifically whom you spoke with that provided the erroneous resubmission date of 1/11?  I will be happy to address that with the individual who misinformed you. 

We apologize for the inconvenience and we look forward to continually serving your electronic processing needs.

[drcavola]

This is a major "hit" in the pocket, i.e. cash flow.  Two thirds of the month of Jan. has passed, and we've seen very little "actual" payments from all the major players, and especially those who send back via EFT's.  What we have seen, however, is LOTS of mail, or pre-estimates, especially lots of Metlife's EOB's faxed over to us, which are pre-estimates.  

The facts that those claims have been resubmitted is one thing.  One the insurance end ... how quickly will they reconcile a pre-estimate claim already processed with a claim for services rendered?

Our answer in our office???? NOT very quickly.

[carolyn621]

Thank you Dr. Cavola! I have been hoping to catch the attention of staff who may understand the impact of Pre-D vs Date of Service claims. No money coming in has a huge impact on every practice. 

Your point on the how quickly PreDs can be converted to payment on the insurance end is yet to be answered.

Carolyn Barnett