Accounts receivable Management Services in USA

Accounts receivable (AR) are uncollected income. These are outstanding balances for services and supplies already provided to patients. Money owed to the medical practice can be from insurance or patient. Who is currently holding your money?

Any loss of income will reduce profit and adversely affect the business. Fees for services have decreased, but operation costs have increased. With decreasing reimbursement, shortage of workers, higher cost for buying equipment and supplies, and cost of maintaining office, practices cannot afford to lose money due to inefficient AR management.

To keep AR low, communication is needed between all departments. All office procedures should be written and available to all employees. When in doubt about insurance, benefits, balance, patient information, or billing requirements, never guess. Office should hav e an Open-Door policy with the billing department so that everyone at the practice feels comfortable to reach out for any patient or billing related question. Keeping AR down increases income and benefits everyone in the practice.

Why Choose FC Billing for AR Management

We take on the challenge of recovering lost income for practices with our AR management team. During our research and recovery, we map out the causes for AR and then create a plan with solution and suggestions to avoid these pitfalls in future. 

We are able to do a practice reboot, reduce financial burden, help create an effective workflow, and increase the bottom line. We work toward a goal of reducing and eliminating insurance and patient aging balances.

Any claims past 60 days need to be flagged and followed on a weekly basis until payment is recovered. Most practices have a limited number of staff and increasing workload, which leads to account receivable going on the back burner. 

The same is true for patient overdue balances. Any patient outstanding past 90 days should be followed up on an urgent basis. Chances of collecting patient balances are much higher closer to the service date.

AR Management Services

Why Is AR Management Services Important?

Insurance Aging needs to be reviewed at a fixed interval for two purposes. First, to make sure correct (or corrected) information has been sent to insurance, related notes are in the patient’s file and a corrected claim (if needed) has been submitted. Second, regular review of insurance non-pays will give the billing team the opportunity to find rejection patterns and avoid the same mistakes in future and bring in payments for all claims faster. Our goal is to get all claims paid under 60 days.

Keeping Account Receivable (AR) low is the best way to ensure your practice income. Working carefully when processing patients, collecting all needed information, following up on all issues without delay, should be established billing work protocol. Some of the best practices for AR Management are as follows:

ar management in medical billing

Ensure Correct Information on file

Even a single spelling mistake in patient’s name will cause a claim denial and drive up your AR. Careful entry of demographic and insurance information is required for avoiding claim denials and managing AR. With new technology embedded into billing software, patients can enter all information directly into the software from comfort of their homes. After all forms are completed by patients, office will need to verify patient demographic and insurance information.

Submit Clean Claims

Claim denials lead to growing AR. Taking few minutes extra to scrub claims for error will save you many hours in follow-up for non-pay claims. Remember to review exam notes to ensure documentation supports all information entered on claims.

Denial Analysis

Read all denial reasons/remark codes on the explanation of benefits (EOBs) and rejections reasons generated by the clearing house. Biller’s goal should be to take note on how to avoid the same mistakes in future.

Timely Follow-Up

Time spent on each claim is added cost to the practice. Time is an investment and to get utmost return on biller’s time, work should be done in an organized manner. Haphazard attempt to do little of everything will actually waste more time and cost more for the practice. One way to keep AR low is to follow-up on all non-pays as soon as you receive them. The longer you put it off, chances increase more unpaid claims.

ar medical billing

FC Billing Service Highlights

We have been successful in increasing practice earnings for all our providers.

Our Workflow Strategy

Before we start billing for any practice, we spend a lot of time studying and researching past billing reports and current outstanding. We take notes on what has been done correctly and what parts of the billing need improvement. By knowing the pitfalls of the past, we are able to avoid claim processing troubles for future.

Teamwork

We work closely with doctors and staff and become a part of the team. We are available to our providers at all times and we are always ready to help.

Our Guarantee

We assure payment on all insurance claims. We take time to study accounts before taking on billing. We are ready to hit the ground running on the first day.

Account Clean-Up

We work on aged claims from previous billing, which are still within the timely filing limit and try to get those claims paid. We also review the provider’s contract and fee schedule to verify insurance fees.

Account Receivable Management

Payment outstanding for 0-30 days are under process by insurance. If the biller has submitted clean claims with required documentation, no other work is needed for these claims.

Claims that are in the 30-60 days range need to be worked immediately. Insurances are probably waiting on additional information from either the provider or patient for these claims.

Any claim over 60 days are at risk of not receiving payments. These claims need immediate attention as well.

Account Receivable Management

i. Effective Verification and Prior Authorization

  • Verify patient’s benefit coverage.
  • Identify primary, secondary, and any additional payers.
  • Determine referral/authorization requirements.
  • Identify Co-Pay, Co-Insurance, and Deductible amounts.
  • Note all findings in the patient’s file.
  • Inform patient ahead of visit about any benefit issues which need to be addressed.

ii. Claim Scrubbing

  • Print out the appointment schedule.
  • Cross check open claims with schedule to ensure claims have been generated for all patient visits.
  • Review exam notes and claims for proper documentation.
  • Identify any billing issues which need follow-up.
  • Review all authorization/referral for validity.
  • Check Place of Service, modifiers, NDC codes, and insurance information on claims.
  • Check insurance cards one more time to make sure claims are going to the proper payer.
  • Know your payers –Maintain active list of payer rules, LCDs, insurance addresses, fax#, etc.

iii. Claim Submission

  • Claims should be created and submitted within 24 hours of patient visit.
  • Submit claims electronically whenever possible. This way you have proof of timely filing. Claims will also get processed and paid faster.
  • If electronic claim submission is not possible, try to get the fax number for the insurance claims department to fax the claim.
  • If you have to mail any claims, keep close track. Ensure the mailing address is correct.
  • Claim Transmission Estimated Time:
  • Electronic transmission – 3 working days.
  • Fax transmission – 3 to 10 working days.
  • Paper claims by mail – 10 to 20 working days.

iv. Claim Follow-Up

  • Review clearing house rejections, software rejections, and EOBs (Explanation of Benefits) for non-pay claims every day. This should be the first thing you do before starting any other work. All issues should be resolved the same day you receive them.
  • Post all payments and review all postings.
  • Review EOBs (Explanation of Benefits) to verify reimbursement with contracted rates.
  • Run end-of-day report to cross check payment posting.
health insurance claim
ar management company

v. Work Smarter

Stay Ahead of Payment Chase – To bring efficiency to your workflow, be proactive. Don’t start planning once a problem comes up; make effective workflow that takes into account for all possible hurdles. Any part of the process that can be automated, it should be done without delay. Automating patient processing and payment processing will greatly reduce errors and help increase the bottom line. Patient processing can be done by giving patients electronic access to their records. For quicker payment processing, register for Electronic Fund Transfer (EFT) with all insurances.

vi. Reports

  • Generate Insurance Aging Report and follow up on every claim past 30 days.
  • Generate patient aging report, send out statements, and follow up on delinquent accounts.
  • Analyze production report to highlight strengths and identify opportunities for improvements.
  • Analyze monthly reports for rejections, pended claims, and unresolved issues.

FC Billing Management Service

Practice management encompasses staff training, patient services, government and insurance compliance, revenue cycle management, and much more. With increasing work requirements and decreasing labor market, medical practices are finding it very challenging to effectively run clinics.

FC Billing team can become an extension of your practice. We can take on the work that your office no longer has the time or the staff to complete.

Employee turnover is very common in all clinics throughout the country. Every time an employee leaves your office, there is a big loss of information. Your office will have to build this information again, piece by piece. Our team maintains all information in a shared file with your office and any time there is an update, we also notify all staff in the practice. We keep your practice running without missing a beat. Our billers are highly trained to process both out-patient and in-patient visits, surgery center claims, account management, compliance, and all billing and coding.

FCbilling provides best ar medical billing

Common Challenges with Accounts Receivable

Most practices write off large amount of account receivable every year because they are unable to collect the outstanding balances. Some common challenges practices face with account receivable management are, staff shortages, knowledge of insurance requirements, coding knowledge, expiration of timely filling, Local coverage determination rules, and informed guidance on billing and coding. Some common billing challenges are listed below.

ar management service common Challenges
  • Coordination of benefit between patient and insurance
  • Inactive Insurance
  • Insurance database errors
  • Medical record requirement for claims
  • Missing referral
  • Missing prior authorization
  • Provider is out-of-network
  • Missing claim information
  • Incorrect insurance information
  • Not meeting payer’s medical policy
  • Not following up with insurance within time limit
  • Incorrectly interpretation of explanation of benefit (EOB)

FAQ

Account Receivable is the uncollected income for services provided by practitioners. Managing account receivable is extremely important for a viable business. Billers are responsible for bring in money for rendered services as quickly as possible and to ensure the accuracy of these payments.

Account Receivable represents lost income. The best business policy is to keep AR as low as possible. To do that, payments must be brought in as close to the service date as possible. Any action that can be taken presently to avoid income loss should not be put off till the next day.