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Physician’s practice and proper cash flow management are directly proportional to each other. Cash flow management is pivotal to a physician’s success. If cash flows are not timely and properly managed, it may adversely affect the overall functioning of a physician. When we speak of issues relating to cash flows, the most crucial factor is a poorly managed A/R.

These days, when specialized A/R services are being offered by billing companies, things have become relatively easier and smoother for a physician as it enables them to attend their patients with more focused mind without any worry on follow-up of claims. The idea behind A/R follow up services is to maximize Collection for physician offices. The process starts as soon as Doctor’s biller creates and sends Health Insurance Claims to various Insurance companies.

There are 2 types of claims Follow-Up:

  • Claims without any status:
    Any claim for which no status is available falls under this category.
  • Unpaid claims:
    This comprises of claims that have remain unpaid over a period of time. This could be for any of the following reason:
    • Authorization Issues;
    • Referral Issues;
    • Medical Necessity and Medical Records requests;
    • Non-Participation with Insurance Network;
    • Terminated Insurance;
    • Coordination of benefits;
    • Wrong Diagnosis;
    • Inclusive Procedures;
    • Partial Payments;
    • Out-of-network claim status and deductibles;
    • EDI Rejections;
    • Letter of Protection from Attorney cases and
    • No status and No claim on File, Workers' Compensation and PIP cases.

The Follow-Up Module:

  • Real time Status Check:
    The billing companies constantly logs-on to various insurance company websites and internet payer portals to access the status of outstanding claims of their clients.
  • Checking through IVR:
    The billing companies also get in touch with Insurance companies directly, wherein an Interactive Voice Response (IVR) system gives the status of unpaid claims.
  • Insurance Company Representative:
    If required, the billing companies do call the Insurance company representative so that they can clear their doubts and better understand the reason for denial of claim. This is usually done when no information can be retrieved from websites of IVR.

Thus, A/R follow-up services are truly handy for physician’s offices as they save time, allow greater flexibility to the physician, keep the follow-up records more organised and maximize revenue at the same time.

The Expert:

MBC is the best in class billing company that has a legacy of keeping the A/R follow-up days to an average of 21 days, in any specialty and any city across U.S.

Their A/R team of highly skilled and trained professionals offers complete solutions to address difficulties that occur in cash flows. The aim is to get funds releases as quickly as possible for the client. They strive to accelerate cash flows and reduce A/R days.

Published By - Medical Billers and Coders
Published Date - Mar-31-2015 Back

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