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Keeping your Clinical Focus Intact with Analysis-Backed AR Management Solutions

January 09, 2013

Every year physicians in the U.S. lose thousands of dollars in the form bad debts. These so called bad debts are Account Receivables that have surpassed the admissible time limit or deemed impossible to be followed up. Once Account Receivables are allowed to languish for more than 120 days, it is difficult, if not impossible, to get them followed up and claimed. It really requires a dedicated AR management practices to monitor and keep ARs active. While care providers’ internal billing staff may be relied upon to a certain extent, they have often been found to be limited in their ability to analyze the reasons behind pending reimbursements, devise strategies to reduce AR days, and speed up realization of claims. But, because these tasks essentially decide the providers’ financial health and progress, they need to be arranged somehow or sourced from somewhere. Therefore, outsourced AR management services seem to be the only way out.

While outsourced AR management services could have right answers to solving AR puzzle, you certainly need to judge your prospective AR management service providers’ credentials on certain parameters:

  1. Ability to analyze long-pending ARs: AR analysis is believed to extract reasons for delay, denial, or long-pending ARs. The reasons so extracted are supposed to be vital leads in resubmitting, following up, modifying, or adjudicating long-pending ARs. Amongst several possible reasons, your AR management partner should be able to cull out reasons such as:
    • claim denial occurring due to patient’s non-eligibility of the insurance
    • delays due to adjudication issues
    • pending for request of clarification or documents
    • denials due to errors in coding and charge entry
    • delay in payment due to insufficient funds with government aided insurance carriers
    • filing of the claims beyond the claims filing limit
  2. Ability to devise systematic corrective measures: Reasoning alone will not suffice; your ARs will be converted into real revenues only when they are backed up with instant, effective, and corrective measures. While most of the AR management providers are generally believed to knowledgeable, it is always safe to be informed of their ability to:
    • Process and systematically follow up with the insurance carrier for paper as well as electronic claims to improve reimbursements.
    • be conversant with knowledge about the insurance companies’ policies and procedures that help process claims
    • Keep records of past AR events that may come useful in dealing with similar future events.
    • maintain good rapport with the insurance company will help the physicians’ office or the physician billing company in solving the issues more effectively
    • handle major rejections and in prioritizing claims
    • verify explanation of benefits, and preserve final payment documents for future use

While ascertaining your prospective AR management service provider is inevitable, you being care providers may not want to be distracted from your primary focus: clinical excellence. Medicalbillersandcoders.com has precisely been an operational partner for medical billing and allied services. With a resource-network across the 50 states in the U.S., we promise to keep your clinical focus intact with some of the best analysis-backed AR management solutions. While our AR management solutions have been inclusive in our total RCM solutions, you can also get them customized exclusively to your practice needs.


Category : Accounts Receivables / Claims Denials