All the money that patients owe you for every service your practice is rendering and billing is termed as A/R (account receivables). Every practice's goal is to maximize its A/R collections, ensuring timely payments for their hard work.A/R management unlike how simple it seems goes all the way from filing appeals, insurance contract updates/negotiations, dealing with underpayment by insurance companies, managing deferred reimbursements, and dealing with bad debts or uncollectible. We use every possible tool like websites, fax, email, IVR, and phone calls with insurance companies to maximize your reimbursements.
Do you know that claim denial and inappropriate A/R Management can lead to major revenue loss for providers?
In general around 80% denials can be avoided.
A/R management has become more challenging in the recent years when practices are dealing with a rise in the payments owed by the patients. An increase in the number of patients on self-pay is making the practices’ job more difficult they are required to realign their collections strategy. Practices should learn to handle the dilemma of high-deductible insurance plans. Dealing with a payer or an insurance carrier is totally a different scenario than following up with the patients who are liable to pay back a major part of their medical bill. In such a situation, A/R management becomes even more perplexed when practices are not ready to handle it and patients are unaware of their insurance plan.
A/R management is only effective if the front desk is working properly. It is not the billing company that communicates with the patients for the payments unless asked to do so by the provider, it is the job of the front desk to effectively communicate with the patients and deliver very clearly about their financial liabilities. So, if you are experiencing a decline in collections despite following an orderly A/R plan, then you should check your front desk staff for the possibility of improvements.
your A/R department must have the necessary skills to deal graciously with patients as well as being able to be persistent with payers.
According to a report furnished by the Centers for Medicare and Medicaid Services (CMS), only 70% of the medical claims are reimbursed the first time on submission. The rest of the claims (30%) is either denied (20%) or misplaced or unnoticed (10%).
For billing patients, 30, 60, and 90 days past due are typical; however, for dealing with payers, the timeline for follow-up can be much shorter and will differ depending on the type of issue being resolved.
It is well known throughout the collections industry that the longer a bill goes unpaid, the less likely it is to ever be paid. On top of that, every time a bill has to be addressed by staff, the cost of the collection goes up, so profit goes down. Getting claims and patient bills paid as soon as possible is vital to keeping revenue up and costs down.
In order to have the depth of understanding necessary to be able to resolve denied claims, medical billers need to have years of experience in addition to their formal training, or they will not be able to find and resolve the issues or understand the payer’s objection so that they can provide the necessary additional information to get reimbursement. We have that experience here at Preferred Medical Services.
Outsourcing your A/R to a professional like Preferred Medical Services ensures that your claims will be quickly filed and tracked until each of them is paid. Our innovative system includes having an experienced biller scrub each claim for errors before it is submitted and follow up on any issues. Your in-house staff doesn’t have time to go through old claims and figure out what the cryptic denial codes mean, but our staff is experts at exactly that.
Give us a call today at 919-237-9080 if you would like to have a more efficient A/R process, increased revenue, and less stress.