Notwithstanding the importance of flawless coding in maximizing healthcare insurance reimbursements from insurance carriers, it is the Account Receivable (A/R) Management that proves decisive in either making or breaking your chances of mitigating denial or delay of your medical bill claims. Most of the physicians, whose primary focus happens to be quality medical care to their patients, never bother to look into this aspect as long as their revenues are not affecting their operational margins. They kind of trust their medical billing department or outsourced Revenue Cycle Management (RCM) service provider. But, despite their best practices, your medical bills are vulnerable to being trashed in Account Receivables for too long; in fact, so long that you may have to relinquish your chances of resubmission.
This is precisely where you are drawn to keep vigilance on Account Receivables (A/R) so that your Account Receivables are kept within the 120-day-limit. The best way to keep track on the age of your Account Receivables is to demand a monthly report from your medical billing department or outsourced Revenue Cycle Management (RCM) service provider. Such monthly reports should aid you in knowing how long your claims are languishing in A/R bracket – 30, 60, 90, 120, or more days. But, having access to aging reports does not mean that they are reliable and acted upon for augmenting the process of claim realization. A good aging report need necessarily exhibit how your medical billing revenue management services are matching up to the challenges in follow-up on patient accounts and insurance claims.
Then, how do you ensure that the reports that you avail of are genuine? Is it practical for you to periodical monitor aging-reports on your Account Receivables? If so how often you need to draw on those reports. Well, the answer is definitely ‘yes’, but not on a weekly or monthly basis for it might impede your clinical efficiency if you are drawn into too much of operational issues. Therefore, ideally you can look to draw on these aging reports at the middle of the year when you can actually track what Account Receivables are slipping into expiry bracket, and speed up the follow-up process on first-come-first-out (FIFO) basis. The significance of FIFO is that it kind of minimizes the chances of your Account Receivables falling into ‘bad debts’ category.
Once you have decided on drawing on aging Account Receivables in the middle of the financial year, and found out those A/Rs that need immediate attention, it is imperative that you follow up with a comprehensive AR Management for augmenting the process of realizing the A/Rs as early as possible. Usually such A/R Management calls for inclusive approach comprising:
- Insurance follow up, where in your unpaid and underpaid claims are analyzed and promptly followed up with insurance companies for speedier realization. Every effort should be made to substantiate your claims as genuine and worthy of being realized fully.
- Denial management, wherein, based on the reasons for denial, your denied claims are taken up for resubmission or appealing with the respective attorneys if the insurance companies concerned refuse to entertain the resubmission.
- Patients follow up, wherein outstanding bills from patients are pursued through individualized tracking of patients’ accounts.
- Reconciliation of credit balance, wherein accumulated revenue is taken for audit to see that every account-related revenue is identified and not duplicated.
- Resolving accumulated and unresolved A/Rs, wherein files are taken up for possible redemption through strategic follow up with insurance companies.
As these functions would invariably seem monumental to physicians, it is prudent to avail tried and tested medical billing management services from credible outsourced service providers. Medicalbillers andcoders.com (www.medicalbillersandcoders.com) – by virtue of leading Revenue Cycle Management (RCM) provider with an array of RCM services comprising patient scheduling and reminders, patient enrollment (demographics and charges), insurance enrollment (for physicians and offices), insurance verification, insurance authorizations, coding and audits, billing and reconciling of accounts (payment posting), account analysis and denial management (EOB analysis), A/R management (insurance and patient), and financial management reporting – may well be your preferential choice.