Taking Control of A/R

One of the most important aspects of medical billing is accounts receivable (A/R), which essentially means charges still awaiting payment for services rendered.  Everyone on the medical billing team must know and understand what A/R means for the practice.  If A/R is neglected, then revenue is not received timely on aging claims, if at all, for the practice.  Maintaining A/R is not always simple, but it is necessary and doing so will generate the maximum amount of income for all employees in the practice.  The following are some essential points for taking control of A/R:

  • Establish an A/R Process. Wood (2017) suggests creating a spreadsheet or other form of record keeping to document A/R on a regular (e.g. monthly, weekly) basis. The spreadsheet should include days in A/R and balances remaining under those timeframes.  MedPro Services maintains A/R records in a location that is easily shared by all members of the team.  A document is created for each of our practices and is maintained continuously.  Each document indicates days in A/R and the amount due for each timeframe.  Without such rigorous record keeping, it is impossible to know what claims remain unpaid and how long they have been aging.  If your medical billing team or company is not performing this service and is not keeping rigorous, detailed records of A/R, then it is advisable to improve upon practices already in place, or to seek new and more advanced services, such as those offered by our team.
  • Team Communication. In her article, Wood (2017) also suggests finding ways to communicate A/R needs with the medical billing team.  She suggests continuous reporting of A/R efforts, comments on each line item to maintain work completed or to be completed, and harboring employee motivation.  MedPro staff would strongly agree with Wood’s suggestions.  We clearly notate on a shared, secure document the work completed or to be completed for each unpaid charge as well as clear and detailed documentation on each charge line in our billing software.  We hold monthly meetings in which each account’s A/R is reviewed and the A/R percentage for each practice is compared from the current to previous months.  Not only does this help with continuing on a trajectory of A/R success, but it helps motivate staff to see that their efforts are paying off or where further improvement and attention is needed.
  • Understand Payor Processes. For anyone who has worked in medical billing, it is common knowledge that some insurance companies pay slower than others.  This is often due to the process in which claims are paid within the company and specific payor guidelines.  Sometimes billing staff may be unaware of certain processes and guidelines put forth by specific insurance companies.  Per Woods (2017), it is important for all staff members to learn the processes for most if not all insurance companies.  MedPro works with clients all over the country and through experience we have come to understand the unique processes of various payors, which can differ greatly even depending on the state.  The healthcare field is complicated and although we are still learning about the guidelines and processes for each payor, we are confident in our ability to accelerate the reimbursement timeline for most payors and have set guidelines for knowing when reimbursement should have been received and when to act on aging claims.
  • Appeals and Collections. Finally, Woods (2017) reminds us of the importance of documenting and following up on appeals and also of maintaining patient collections.  Appeals processes can vary greatly depending on which insurance company the appeal is for.  Some companies and some states require specific forms.  Some require paper appeals, while others prefer electronic ones.  The appeals process can be frustrating, but following up on submitted appeals is critical.  At MedPro, we keep all appeals in a secure, sharable location where all team members may access appeal information at any time.  We follow-up on appeals in a timely manner to ensure receipt of the appeal as well as the status of an appeal.  If, for whatever reason, an appeal is said to have not been received by an insurance company, documenting appeals and keeping copies of appeals will make follow-up and resubmission all the easier.  Patient collections are also necessary to consider.  It is highly recommended that each practice has a collection agency on hand.  The collections process, however, must be maintained by your billing staff.  Keep records of all patient accounts sent to collections, which that are being held out of the collection process and why, and the status of collections paid.  All of this should be notated on a secure and shared document as well as on each patient account.

References:

Wood, E. (2017, January). Quick tips for managing A/R. Healthcare Business Monthly, 42-43.

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