The Texas Prompt Pay Act requires HMOs and insured PPOs to pay clean claims within a set timeframe. Texas law provides for payment no later than 45 days after the date a health plan receives a nonelectronic clean claim and no later than 30 days after receipt of an electronic clean claim.
But prompt pay laws are all about the details. Many claims may be paid outside the 30-day window for legitimate reasons. How effectively prompt pay laws work for you depends on your claim submission process.
On July 23, during the noon-1 pm CT lunch hour, a new live TMA webinar will address prompt pay as it relates to your revenue cycle and claim submission process. Prompt Pay and the Revenue Cycle — Part II: Clean Claims discusses the following concepts:
- The impact of patient responsibility on prompt pay,
- Submitting clean claims,
- Accounting for accuracy and timeliness of receipts, and
- Appeal and reconsideration requirements prior to prompt pay action.
The final webinar of this financial series, Effective Collections Techniques, will be broadcast live July 30, also during the noon-1 pm CT lunch hour. This webinar will address the discomfort many feel about asking patients for money and will outline how to reduce lost revenue, how to create a collection policy for your practice, how to implement effective and tactful collection strategies, and how to talk to patients from whom you need to collect payment.
TMA plans to release all three webinars on demand in the coming months. Stay tuned for details.
Action, July 15, 2014