Accounts Receivable

Accounts Receivable

Accounts receivable?or A/R is a term used to denote money owed to your practice for services you have rendered and billed. Any payments due from patients, payers, or other guarantors are considered A/R.

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Why is it Necessary to Have A/R Team for Healthcare Services?

The accounts receivable follow-up team in a healthcare organization is responsible for looking after denied claims and reopening them to receive maximum reimbursement from the insurance companies. Medical billing A/R and revenue cycle management handled by an in-house team is a thing of the past. Today, it demands billing professionals with a specialized skill-set to look after the A/R follow-ups.

It must be noted that along with A/R follow-ups, there are several other important processes such as?charge entry, verification, and payment posting that need to be completed first. During these procedures a medical billing specialist determines the exact procedure code and diagnosis code based on the treatment plan. There are chances that the insurance company will deny claims if they don't adhere to the rules, therefore it is crucial to have a dedicated A/R team who can follow-up with the insurance firm to resolve your denied claims.

What is Account Receivable Management?

Account Receivable (AR) is the money owed to Providers or medical billing companies for the medical care rendered to patients. The generated invoices are sent out to insurance companies or patients for payment. It is important that the staff keep a tab on the AR and see if the payments reach on time. In simple words,?Account Receivable Management?is a collection of processes such as, identifying denied/unpaid claims, re-filing the corrected claims, minimizing AR days, and eliminating aged AR.

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Manage Denials:?Identifying the root cause for claim denials is one of the important processes in Account Receivable management. The staff must be highly skilled to analyze the reason for claim rejection, correct the claims and re-file without delay. Also, it is essential to examine denial patterns and find proper solutions to eradicate future occurrence of denials.

Timely Follow-up:?Following up on the AR on a timely basis is very important for uninterrupted cash flow. A good Account Receivable management team will keep track of all claims that have been filed. Also, it will execute an action plan immediately if the claims are not paid within the 30-day time limit. The team will also ensure that there is no underpayment or overdue payment.

Patient Follow-up:?After the introduction of self-pay, medical billing companies had to rely more on the patients than insurance companies for payments. If there is any outstanding balance, the Account Receivable management team should follow-up with patients through phone calls or emails, so there are no delays. Good patient-provider relationship is the key to timely payments. Another best practice is to explain the patients about their financial responsibilities before providing the care.

Periodical Audits and Reports:?One of the top qualities of a good Account Receivable management team is conducting audits frequently to learn areas of improvement, check for problems, and assess risks. Then, the team submit reports on the audits conducted. Such reports include aging AR reports, outstanding payment report and more. These reports will ensure there are no future claim denials and payments reach on time.

6 Reasons Why A/R Follow-up is Important in Medical Billing Process

The major challenge most companies face in the medical billing process is A/R follow-up management. So why is it so important?

Here are some of the more popular reasons

1. Financial Stability of the Hospital:?The financial stability of any healthcare service provider is highly dependent on maintaining a positive cash flow. The hospital has to maintain a steady flow of revenue to cover expenses so as to provide patient care services, and the A/R department ensures this is taken care of.

2. Helps in Recovering Overdue Payments:?A/R follow-up helps all hospitals, physicians, nursing homes, etc. to recover the over-due payments without any hassle. When there is a team which is constantly involved in the claims follow-up procedure, it becomes easier for the healthcare providers to receive payments on time.

3. Minimize Time for Outstanding Accounts:?The primary objective of A/R management is to minimize the amount of time that accounts are allowed to remain outstanding. The team tracks accounts that have not been paid, assesses a suitable action required to secure payment, and implements procedures for secure payment.

4. Claims Never Go Missing:?The biggest reason for delay in payments is due to the claim not being received. This usually happens when paper claims are lost. To avoid this, it is wise to send the claims in the electronic form. If the claim has been followed-up and you are aware that the claim hasn't been received, then it becomes easier to send another request for the claim soon.

5. Claims Denied can be Followed Up:?Depending on the denial reason, you can actually send a new claim request with the required corrections made. By calling the insurance companies and finding out the denial reason instead of waiting for the denial reason on mail, the A/R department can ensure that all claims are followed through till the end.

6. Recover Claims Kept Pending for Information:?Sometimes claims are kept pending for a certain amount of time due to additional information needed for the member. By following-up properly the A/R team can inform the member about the situation and then a suitable action is taken so that the process can be sped up.

Our Mission is to help our customer get control over their time to spend it as they prefer and have the financial peace of mind from knowing that their cash flow is always maximized.