Frustrated with Client Responsibility Action Required tasks? Do you wish you could avoid these? Great news! We can, and we should!
 
As we work to improve our process, system, and add additional teammates to support the changes and order volume, it is essential that the orders are updated with the proper docs required and document type (S, P or D), from our first review in the DR queue.
 
We understand the time investment needed with each order during our first review either in Coding and Pricing or in Docs Required. This first review is the best time for a Funding Specialist to review the clients’ benefits for any estimated Client Responsibility.  If the client is expected to have any out-of-pocket costs, the Funding Specialist should not only add the “P” requirement to Client Responsibility in the Payer tab within the order but also take that moment to reach out to the client or guardian, via the Phone, to go over any possible balance that may be due prior to or at delivery.  Why a “P” document?  Since Client Responsibility is not required at Submission, but is required prior to delivery, the most appropriate selection at the start of the order is to select “P” to not stop the order from moving to submission to the payer.   Don’t worry, the order will still be stopped at PPQA if we haven’t confirmed the client’s ability to pay before then, that’s why we may see orders on a Funding action Required task.
 
While we may not be collecting the balance at the start of the order in all cases, we are giving the client and/or guardian advance notice of any balance that could be due going forward.  This is a great opportunity to secure a verbal agreement with the client or guardian that they understand their financial responsibility as well as to confirm they can pay this amount or review alternative options such as payment plans. If confirmed the client can pay at delivery, then we can secure a credit exception and change the “P” requirement for Client Responsibility to a “D” requirement while noting the order of the conversation and agreement. By taking these steps, you avoided an Action Required for Client Responsibility on that order!
 
We also want to remove the element of surprise and disappointment from our clients when we need to cancel their deliveries because no one had previously advised of their balance due and they now cannot afford to pay.
 

We may feel frustrated with Action Required orders for Client Responsibility but imagine the disappointment and frustration our clients must feel when we cancel their deliveries because we missed a step in the process. We all know this is not a new step but rather a need to break away from our traditional habits by creating a new habit of calling the client after we add the Client Responsibility requirement to an order. Repetitively completing these steps will create this new habit thereby reducing Action Required orders for Client Responsibility and keeping our clients moving!