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Thursday September 27, 2012
Why Most Physicians Get Paid Within 60-90 Instead of 14-30 Days?
Rising AR days is a major concern with physicians as it can significantly impact a practices bottom line.
Minimum Payment Days: On filing a clean claim the minimum time a physician will be paid:
  • Federal payers - (Medicare/ Medicaid) pay clean claims within 13-15 days
  • Other commercial payers - pay clean claims within 27 to 30 days
  • Industry Standards State Claims in reality can take anywhere between:
  • 40-169 days to be paid, with an AR cycle of generally 60-90 days
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    Why delay? -- Get It Right the First Time!
    Claims are typically delayed/denied due to human error or misfiling. Variety of other factors influence why claims are not paid immediately, like:
    • Claim may not be for a covered contract benefit
    • Patient's preexisting condition is not covered or patient coverage has been cancelled
    • Case is under consideration as Workers' compensation is involved
    • Payer considers the physician's procedure experimental
    • Preauthorization for a procedure or for hospitalization not obtained
    • Services were provided prior patient's health insurance contract went into effect
    • Payers may ask for additional information
    • Payer has requested information about another carrier for coordination of benefits
    How to get paid faster? Self-assessment can assist in finding cause plus a maintenance assessment:
    • How many claims were submitted in the recent 30 day period?
    • Of those claims approx. what % were denied and most frequent reasons for denial?
    • Of those claims approx. what % were delayed and most frequent reasons for delay?
    • Does the denied or delayed % vary between paper and electronic claims?
    • Does the billing staff track the % of claims that are denied on the first submission?
    • Is there a policy in place for bad debt collection?
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    Short of time to apply the above into practice? -- Getting paid faster with the help of a billing service!
    • Billing errors and late payments can cost a practice a loss of nearly 10% - 30%
    • Outsourcing all or portions of the billing operation to specialists is a growing trend in the US
    • Top 20 outsourcing firms, based on national healthcare clients, reported 13.1% in 2010 to 2011
    • US Healthcare outsourcing has a high projected growth rate of 31.9% from 2011 to 2016 .
    Reducing your AR days with MBC experts can reduce your AR days by: Weekly & monthly reporting, review of EOB's, reason for denials, getting required documentation, regular follow-up process, dedicated appeals team and studying of contracts before it reaches appeal stage.
    Serving healthcare for over a decade by applying all the above we have a past track record of:

    Savings: nearly 32% + AR days reduced: 30-40% + Reduced Denials: nearly 10-15%

    Cleaner claims: 97% + 1st pass denial rates: less than 3% + Enhanced collections: 10-15%
    Resulting in thousands of dollars of added revenue!

    Toll Free Number - 888 357 3226
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