When should a Medical Administrative Assistant follow up on outstanding claims?

Following up on outstanding claims is an important part of a Medical Administrative Assistant's responsibilities to ensure timely reimbursement for services rendered. The recommended timeframe for this follow-up is typically 30 days after submission if payment has not been received. This is because many insurance companies have a processing period during which they evaluate and authorize claims. By the 30-day mark, it is reasonable to expect that a claim should either have been paid, denied, or be under review, allowing for the administrative staff to check on its status if no payment has been seen.

Waiting longer than 30 days may lead to increased delays in revenue and can complicate the claims process further, while following up immediately after submission may not be practical, as claims generally need some time to be processed. Additionally, following up only after receiving a patient's complaint does not demonstrate proactive management of the claim process and could negatively impact patient satisfaction. Lastly, waiting until 60 days introduces unnecessary risk of further delays and potential issues with the claim, as many insurances expect communication well before that point. This proactive approach not only facilitates efficient revenue cycle management but also ensures patient billing issues are handled in a timely manner.