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Tyler Williams, Director of Strategy, AR Optimization, ZOLL Data Systems | March 5, 2019

Returned Mail: 5 Demographic Discrepancies

(2 min read) What’s more frustrating than coming into work to find a pile of returned mail sitting on your desk? Maybe you’ve personally used up hours getting statements ready. Or you’ve spent huge sums of dollars with outsourced statement vendors promising “demographic correction,” only to have a fraction of your statements be delivered to the right patient at the right address.

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Your first thought might be, “How could this happen? We got the information directly from the patient.   There shouldn’t be this much returned mail.”  Your team might be the best of the best, but sometimes things are out of their control.

Here are five demographic discrepancies that cause returned mail:

Return to Sender
Patients simply do not want to pay their bill. They receive a statement and automatically put it right back in the mail marked “Return to sender.” Or, maybe patients have insurance. But they are angry or confused as to why you’d send them a statement. Once again, ‘return to sender’ is their message of choice.

Payor Address
Sometimes the payor has an address on file that’s different from the current or correct address for the patient. The payor uses the address on file to submit the claim—an address that often gets confused with the residence, resulting in returned mail.

Emergency Pick-Up
The emergency pick-up address often differs from the patient’s residential address. For instance, they could be at the home of a friend or family member, or at a restaurant or ball game. With emergencies, there isn’t always time to ask questions.

Temporary Address
Students, ‘snow-birds’, and renters are a few examples of patients who sometimes have a temporary address. Most of the time, this address differs from the address the payor has on file, since it isn’t their permanent address. Receiving medical care while patients are ‘home away from home’ could result in the wrong address, leading to denied claims and returned mail.

Keystroke Errors
Even the best data entry personnel miss an occasional keystroke.  It’s not just the incredibly creative names people give their children these days, but it can also be that 123 becomes 213…and mail doesn’t show up.

While everyone in billing knows these problems exist, many have chosen to treat the symptoms instead of treating the root cause. To bring resolution to these and other associated discrepancies, it’s important to set up demographic verification processes on the front-end, before the bad data washes downstream to claims, statements and other points of the revenue cycle.  Some of the results in doing so are:

  • Reduced cost of claims
  • Less returned mail
  • Fewer claim rejections and payment delays
  • Minimized HIPAA and breach risk

Have you come across any other reasons for returned mail? Share in the comments below!

Want to learn more about ways to avoid returned mail? Contact us or read more about how PayorLogic’s technology and services support your efforts here.

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More About the Author:

Tyler Williams, Director of Strategy, AR Optimization, ZOLL Data Systems

Tyler Williams is a successful entrepreneur whose experience in healthcare reimbursement, business, and data combine to provide deep industry insight into the challenges faced by medical providers and healthcare professionals. As the RCM Director of a large, pediatric emergency medicine firm in the 1990s, Tyler experienced the challenges of bad payer tactics and obtaining accurate and timely payer information from the patient. His struggles inspired him to pioneer what the industry now knows as insurance discovery and healthcare identity (or demographics verification) and to launch the company, Payor Logic. Under Tyler’s leadership, the company grew into a multi-million-dollar organization serving more than 90% of the ambulatory outpatient market. Payor Logic was acquired by ZOLL Data Systems in 2019. Today, Tyler serves as Director of Strategy, AR Optimization for ZOLL Data Systems and ensures that providers have access to high quality data reflecting the patient’s unique financial characteristics to enable optimal and compliant reimbursement. Tyler is a nationally recognized speaker on AR optimization and innovation. He is a past board member of Steppingstone Ranch, a nonprofit equine therapy program serving at risk teenage girls.