As healthcare costs rise, it is more important than ever to ensure that specialists in specialties such as obstetrics and gynecology (OBGYN) get compensated for their services. However, raising your accounts receivable may be an issue due to patient and insurance company late payments.
The good news is that you may use a variety of techniques to expand while keeping the organization's finances intact. Discover our top ideas for improving paid accounts receivable in the healthcare business, particularly OBGYN, ranging from payment schedules to accelerating your billing procedure.
Accounts Receivable (AR) for OBGYN Healthcare Calculation
Accounts Receivable (AR) in medical billing refers to how long it typically takes an OBGYN healthcare provider to receive payment for services rendered. Here's how to determine it:
Calculate the entire balance of accounts receivable (AR)
Determine the OBGYN hospital's total outstanding debt first. This covers all unpaid bills for performed services that have not yet been paid for.
Determine the average daily income
To compute this, divide the total income earned during a certain period (annually) by the total number of days in that period.
Calculate Days in AR
The daily average income is divided by the total amount of AR balance. This will indicate the average time it takes for the OBGYN hospital to be compensated for the services you have rendered.
Average Daily Revenue / Total AR Balance = Days in AR
For example, if the total amount of accounts receivable (AR) at the OBGYN medical facility is $200,000 and its daily average revenue is $20,000, then:
$20,000 divided by $200,000 = 20 days in AR
This implies that the OBGYN medical facility must wait an average of 20 days before being reimbursed for the services provided. The Calculate Days in AR tool helps healthcare providers evaluate the effectiveness of their revenue cycle management in billing and collection operations.
Strategies for enhancing AR management in OBGYN practice
Implement Best Practices in Billing and Coding Management: Here are some approaches to improve OBYN billing.
- Preventive Therapy: Avoid refusals, delays, and denials to reduce time to reimbursement and income possibilities.
- 48-Hour Turnaround Time: To ensure quicker reimbursement, submit claims within 48 hours of receiving the charge.
- Set Clean Claim Goals: Target a clean claim rate of 97% or higher to analyze front-end errors effectively.
- Handle EDI Rejections Promptly: Address EDI rejections on the same day and use data to refine claims processes.
- Employ trained medical coders with OBGYN knowledge to ensure correct coding.
- Use the appropriate modifiers: For OBGYN services, add suitable modifiers like LT, RT, and 50.
- Follow the payer's guidelines: Respect payer policies to prevent denials and rejections while coding.
- Avoid Over- or Under-Coding: To guarantee correct payment, code precisely—neither under- nor over-coding.
Implement a front-end-driven revenue cycle process
Implementing a front-end-driven revenue cycle process in Obstetrics and Gynecology (OBGYN) medical centers requires transferring back-end duties to the front end. This involves finding out whether the patient has insurance, getting pre-authorization if necessary, and calculating their financial obligations before starting treatment.
Doing so allows for pre-payment opportunities, reduces collection costs, and minimizes bad debt exposure. Obtaining pre-authorization upfront also prevents rejected claims and maintains control over days in accounts receivable (AR).
Understand and define your AR aging benchmarks. Clearly, to gain a comprehensive understanding of accounts receivable (AR), it's crucial to analyze aging beyond just the total days outstanding.
- Analyze Payer Breakup: Assess if all payers meet average payment timelines or if delays stem from specific payers in your mix.
- Set Aging Thresholds: Run detailed reports with payer breakdowns to establish clear thresholds for AR aging.
- Compare with Industry Benchmarks: Benchmark your thresholds against industry standards to ensure realistic targets.
- Minimize Credit Balances: Reduce credit balances in AR to maintain accurate calculations and avoid misleading insights.
- Monitor Aging Closely: Continuously track aging metrics to gauge progress towards goals and identify areas needing improvement.
Perform AR follow-up and maintain follow-up promises
- Prioritize Payer Follow-up: Organize the payer follow-up list by priority, focusing on the oldest claims and high-value amounts. Consider addressing trends affecting multiple claims.
- Set No-Response Threshold: Establish a threshold for no-response claims and promptly initiate follow-up beyond this limit.
- Document All Follow-ups: Maintain thorough documentation of all follow-up actions to track progress and ensure accountability.
- Define Follow-up Actions: Develop clear follow-up actions with designated next follow-up dates, ensuring consistency across processes.
- Implement Follow-up Filters: Utilize filters to identify follow-up commitments and diligently adhere to them, facilitating closure and resolution of claims for timely payment.
Conclusion
In the dynamic financial landscape of OB-GYN medical centers, efficient management of healthcare accounts receivable (AR) stands as a pivotal factor in organizational success. Declining AR turnover rates and deteriorating aging schedules pose significant challenges for cash-strapped medical facilities and hospitals, making streamlined OB-GYN billing processes essential to ensure financial stability.
Addressing the complexities of a distressed revenue cycle demands a comprehensive approach. It necessitates identifying underlying issues within the revenue cycle framework and instituting workflow mechanisms to align with strategic objectives and enhance cash flow dynamics.
Through the adoption of industry best practices across the revenue cycle, considerable reductions in cycle time can be achieved. A mere reduction of 5-7 days in the payment cycle can yield substantial improvements in cash flow, facilitating the sustainable operation of healthcare practices.
Medical Billers and Coders (MBC) have a proven track record of assisting numerous OBGYN Medical Centers in not only pinpointing areas of improvement but also implementing optimized workflows to enhance OBGYN account receivable services and significantly bolster cash flow. Explore our OBGYN account receivable services for further insights.
Medical Billers and Coders implement efficient strategies to reduce Days in Accounts Receivable and enhance revenue flow for OBGYN practices. Contact us today!
FAQs on Improving Days in Accounts Receivable for OBGYN Practices
1. What is considered a good benchmark for Days in Accounts Receivable (AR) in OBGYN practices?
A good benchmark for Days in AR in OBGYN practices is typically between 30 and 40 days. Practices should aim to stay within this range to ensure timely reimbursement and maintain healthy cash flow.
2. How can pre-authorizations help reduce Days in AR for OBGYN services?
Pre-authorizations ensure that the insurance company approves the procedure before it takes place, reducing the chances of claim denials and speeding up the payment process. This proactive approach minimizes delays and helps keep Days in AR low.
3. What are the most common causes of delayed payments in OBGYN billing?
Delayed payments often result from coding errors, lack of proper documentation, missing pre-authorizations, and payer-specific policy non-compliance. Addressing these issues with best practices can significantly improve payment timelines.
4. Why is it important to set a clean claim rate goal for OBGYN practices?
Setting a clean claim rate goal of 97% or higher ensures that most claims are accepted and paid on the first submission, reducing denials and rework. A high clean claim rate directly correlates with improved Days in AR.
5. How can outsourcing OBGYN billing services help reduce Days in AR?
Outsourcing to a specialized billing service like Medical Billers and Coders (MBC) provides access to expertise in OBGYN billing and coding, ensuring accurate claim submission, efficient follow-ups, and timely reimbursement. This reduces Days in AR and enhances overall revenue cycle management.