In the dynamic landscape of healthcare financials, the crucial time window of 120 days reveals a concerning statistic: healthcare providers typically recover a mere 10 cents for every dollar owed to them. Navigating the intricacies of revenue cycles becomes pivotal for rectifying inefficiencies and optimizing accounts receivable collection. The implementation of meticulous administration, comprehensive AR reporting, and vigilant claims tracking can ultimately salvage revenue that might have otherwise been deemed irretrievable. Yet, the demands of this process can often outweigh a provider’s capacity or expertise. This is where the strategic decision to outsource AR collections to a proficient healthcare payment recovery partner comes into play.
Healthcare providers need to ensure they receive payment for the medical services they provide, whether it is from the insurance provider or directly from the patient. It is important to check a patient’s insurance eligibility during registration to determine copays and deductibles that are due, as well as to confirm that the insurance status is active.
When contacting the patient to remind them of their appointment, it is helpful to inform them of the expected payment amount for the service they will be receiving. This increases the likelihood of the patient paying their dues during their visit. Additionally, having the patient sign an agreement acknowledging the charges they need to pay and obtaining their credit card information at this time makes it easier to collect any outstanding dues.
It is crucial for the administrator to enter the correct service codes for the services the patient has availed. This ensures accurate billing and allows for the submission of claims to the insurance provider. Given the vast number of medical codes, it is essential to be diligent to prevent coding errors, as they are a common reason for claim denials under Medicaid and Medicare. Providers often spend a significant amount of time researching, manually processing, and appealing denied claims.
To streamline the accounts receivable collection process and alleviate the burden on your staff, consider outsourcing this task. Outsourcing can help reduce coding errors and accelerate the collection of accounts receivable. It is advisable to avoid mentioning aging buckets in medical bills, as this may prolong payment delays. Instead, clearly indicate the outstanding amount as “Due Now.” Generating monthly accounts receivable reports and categorizing them into 30, 60, 90, and 120-day buckets will help identify any outstanding debts and determine the reasons for overdue balances.
It is possible that the billing team may be solely focused on generating bills, leading to a higher chance of claim denials. It is crucial to proactively work on resolving insurance pending accounts to improve cash flow. If two patient statements are sent without a response, it may be necessary to reach out to the patient via phone and establish an installment payment plan for those struggling to pay the full amount at once.
To identify trends and monitor key metrics, compare your current aging accounts receivable with those from the same period in the previous year. Important metrics to track include denial rates, days in accounts receivable (DAR), and collection rates. When running aging accounts receivable reports, it is advisable to use the date of service rather than the date of billing to check for any time lags between these two points. In cases where claim denials have new or unfamiliar reasons, consider contacting the insurance carrier directly to resolve any issues.
Big data technologies can greatly assist healthcare facilities, such as hospitals, in identifying Medicare account underpayments and identifying process and billing system breakdowns that result in returned or denied claims. These technologies have shown to help recover lost payments, reduce costs, and increase revenue by 30%. Outsourcing providers often have access to analytics software, saving you the expense of investing in these solutions.
Payments from patients and insurance companies are the primary sources of revenue for healthcare providers. Streamlining the accounts receivable process ensures that payments are received on time, leading to a more consistent revenue stream. Medical billing specialists play a crucial role in identifying unpaid accounts, devising collection strategies, and implementing them. By promptly following up on claims that are due after 30 days, underpayments and outstanding debts can be minimized.
In order to maintain a harmonious patient-provider relationship, an accounts receivable management team communicates with patients regarding out-of-pocket expenses before they receive medical care. If payments are due, they efficiently follow up via email and phone.
With their expertise in managing claims, an accounts receivable management team can quickly identify reasons for claim rejections, take corrective actions, and resubmit the claims. They also analyze patterns in such claims. Additionally, partnering with an outsourcing provider for accounts receivable management allows for regular audits to identify any issues and areas for improvement. Reports are prepared after these audits, summarizing outstanding debts, minimizing claim denials, and facilitating the collection of payments.
The Philippines is a cost-effective, high-quality destination for outsourcing healthcare collections. The AR agencies here have experienced agents who are well versed in the American way of working, so they are effective in recovering payments without alienating customers. Outsourcing AR to a Philippines agency will ensure you have a team of experienced professionals dedicated to following up with your customers, ensuring you receive timely payments.
The healthcare provider, based in California and specializing in sleep apnea solutions, faced challenges in collecting accounts receivable. Due to their overextended staff, they decided to seek assistance from an outsourcing provider to enhance their collections process. After thorough research, the healthcare provider selected Flatworld Philippines.
The Billings & Collection team at Flatworld Philippines diligently pursued outstanding invoices, resulting in a significant decrease from 500 to about 100 overdue invoices – an impressive 80% reduction. Additionally, the team exceeded their sales target by double, leading the client to revise targets upward. Impressed by the outstanding results, the healthcare provider further engaged Flatworld Philippines for data entry, insurance verification, and intake/scheduling tasks.
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