5 Tricks in Medical Practice’s to Improve Your Accounts Receivable


Insurance companies are increasingly inventing complex and new set of rules for the medical procedure which has resulted into loads of denials and underpayment.  Doctors and pharmacist are increasingly finding it difficult under the ever-changing federal laws for practice and drugs. The recent data will also show the plight of doctors.

Unpaid Amount

Only 70% of the claims submitted are paid first time according to the research Center of Medicare and Medicaid (CMS). The other 30% denied claims are either lost or ignored or never resubmitted. Out of those 30% denied claims 60% claims are never resubmitted.

What’s more shocking is the fact that doctors aren’t even paid in full according to their contracts. The medical group management association (MGMA) estimates that payers are currently underpaying the doctors by almost 7% to 11%. So on average, a doctor is not paid 25% of their amount that they have earned by treating a patient. This has translated to a total of $125 billion left on the table by American Health Care industry.

Currently, doctors are shifting away from private practices as the sustainability on lone basis is difficult with the requirement of software’s and extra staff for revenue cycle management.

With unpaid and underpayment doctors are looking for innovative ways to approach the problem. Here are certain methods to use which you can amplify your ARs

Claim submission management

If the submitted claim is not paid up in the first submission cycle the likelihood that the claim will ever get paid also reduces drastically. One of the best methods to get paid when the claim is submitted is to identify the potential claim which might be rejected.

Identifying such claims using an intelligent engine that constantly adapts and updates according to the rules and regulation of payers. 

Using a software solution to constantly update and adapts after analyzing all the denied claim of the insurance company from all doctors.

Payment Tracking

One of the major problems with doctor’s payment is the underpayment. Now every doctor has a different contract with each payer or insurance company.

Now if four people come in with a same medical condition that needs same doctor but each patient has different medical insurance then each insurer pays a different amount.

For this, you need software to track all payments. You can allow the contracts which pay full payment or even used to predict future collections.

 Daily ageing of receivable

Traditionally receivable are tracked based on 30-day increment period. But now as each payer has a different schedule, they will need a different set of actions. Two receivables which are 30-day old could require different actions from different payers.

With no 30-60-90 days plan being followed a manual monitoring is needed for each claim. Practice can improve their days-sales-outstanding (DSO) with constant monitoring of all claims. The sooner practice follow-up with insurers the better chance you have of being paid than the claim being lost or ignored. Practice management software can help keep track of this without manually doing this work.

Work-flow management

From patient appointment scheduling to collecting reimbursement from payer requires a tedious process of documentation this all can now be done electronically with software. The manual work makes the process error prone and less efficient.

Every mistake in the documentation will be added on till the claim submission creating a bumpy ride for Accounts Receivable. Most efficient medical practices use practice management software to automate the workflow management.

Top notch software will schedule the patient visit for you, look through claim system for you and track all your AR from outsourced billers and coders. Send customized emails to patients informing them about their appointments.

Modern health care reporting and analysis

Modern health care industry is much based on making the right decision which can only be achieved with complete access, and well-organized data. Data can be your accomplice for growth if analyzed with purpose. Modern healthcare trends are important for achieving revenue growth.  This all can only be done when you have all your data at one place.

It is important for being able to mine data when you are on the go, so you can create reports and have live analysis. The process of data mining can be eased using practice management software providing you with UX to access data.

Things you should look into your practice management software

  1. Automate Work queue

The work queue will simply automate and update as your front desk will update the patients’ appointment. The doctors can reschedule or provide confirmation on the same appointment. This requires minimum paperwork and more freedom for doctors to operate.

  1. Specialty routing

Specialty routing is a very important task for hospitals which deals with complex diseases which require the involvement of more than one specialty. With specialty routing all the doctors working on a patient can go through their medical history and reports without any manual paperwork using practice management software.

  1. Advanced tracking

The physician should be able to track all the claims submitted and the duration of the submission. The underpayments and denied claims will provide an idea to the doctor about the insurance companies’ policy. Now many insurance companies are providing doctors with online tracking facility which helps them to check the status of their claim. This also helps in planning the future endeavors of the practice.

  1. Denial tracking

Denial tracking will be one important part for you to minimize your denied claims in practice. The justification, coverage, authorization and many other aspects can help standardize the same category denied claims into different payers. Providing you with numbers and insights of denied claims.

This entry was posted in Accounts Receivables, Claims Denials, DME Billing, Insurance / Payer, Insurance / Payer Underpayment, Medical Billing, Medical Coding, Payment Models, Revenue Cycle Management (RCM) and tagged , , , . Bookmark the permalink.


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