Take a Deep Dive into the Claims Process
Every insurance company negotiates contracts with individual care providers. Your contracts with Blue Cross/Blue Shield and Aetna, for example, will likely pay you at different rates for the same services. Ultimately, though, you are responsible for ensuring that you are paid what you are due.
That’s why it pays to know your contract rates and make sure you are being paid the full rate. If you’re not watchful, an insurance company can underpay in a way that seems insignificant on a case-by-case basis…but can add up to not-insignificant losses over time.
Medical billing experts often recommend deliberately overbilling to ensure that you collect the maximum possible amount per claim. For example, Blue Cross/Blue Shield of Minnesota’s contract stipulates that it pays 90 percent of the contracted rate or allowed amount, whichever is less. Overbilling will ensure that you maximize what you are paid.