Delay in insurance payment?
The aforementioned statement is enough to give a healthcare practice’s operator sleepless nights.
Optimizing account receivables is crucial to keep the healthcare facility running in a stable condition. Streamlined AR results in fast track claim reimbursement with its timely follow-up, comprehensive denial management to contribute to an improved revenue cycle management. Since AR management is a relatively intricate process, healthcare facilities prefer outsourcing AR specialist from billing and coding experts like Medphine. Medphine’s AR team holds extensive expertise in simplifying clogged revenue in old AR by thoroughly inspecting and identifying the problem areas and framework an all-encompassing solution.
Account Receivables is denoted by different terms in different facilities such as patient account or client’s account, but regardless of the terminology, the ultimate goal of AR is to reduce the collection time to the minimum.
Medical billing report is vital to determine the health of the practice. Of all the reports, there are specific reports, generating and keeping a tab on which prove beneficial to the healthcare practice in the long run, financially and otherwise, one of which is AR Aging report, which helps in identifying how well is the billing and collection been done. The objective is to make sure that the collection is done within the 45 days and if not, identify and work on the problem areas. Medphine AR specialists segregate the aging reports per the days into different aging bars and implement a specific solution to each category, post-establishing the underlying problems.
Before discussing what strategies can be implemented to improve the AR Management, it is pivotal that we know what some of the critical elements of a medical AR management are:
ADEQUATE MANAGEMENT OF PATIENT’S HEALTH:
Per the state and federal health care rules and regulation, a practice needs to furnish the details such as privacy and security, maintaining confidentiality, maintenance of medical records, filing and retrieval and such patient’s health information to ensure adequate management.
ACCURATE CODING CHARGE:
Each clinical area has a specific charge capture with particular specialty coding. Unerring charge capture is necessary for precise documentation, billing, and upcoding. There are various domains included in the charge capture such as critical care, maternity, surgical unit, etc.
REINFORCING PATIENTS RIGHTS:
Patient’s rights within the medical office include confidentiality, informed consent, complaints, patient’s health information, their choice in seeking treatment from a specific medical practitioner and more.
It is imperative for every medical practice to have a sturdy medical office compliance program which is made up of both ethical and legal concepts.
SERVICES FOR PATIENT:
Patient financial service and access service are responsible for ensuring timely and accurate collection and billing. These division perform better when provided with qualified staffing, and ample resources.
Implementing the following strategies can help reduce the number of AR days:
STUDY THE DATA:
Make sure that the statistics are checked regularly. Keep a tab on your average AR days and identify the faulty payers and if they are consistent in making a late payment, sort the issue individually. Furthermore, it is vital that you do not ignore the aging AR, resolve them as early as possible.
PRIOR VERIFICATION OF INFORMATION AND PATIENT’S ELIGIBILITY:
A beforehand check will eliminate the hassle of queueing up on the front desk, resulting in decreased efficiency. Verify all the necessary information from the contact address, phone number, insurance status. A more effective approach would be to implement batch eligibility system, ensuring that the practice has updated information and any gaps or changes can be promptly looked into.
KEEP THE TIME OF SERVICE RENDERED AND BILLING SHORT:
Make sure that the bills are sent to the patient and the insurance company as soon as possible not to delay the claim reimbursement. While you are at it, it is crucial that the billing statement is adequately broken down per the dates on which the service for rendered for effective communication with the patient. Another effective method would be to implement the provision of 100% co-payment to be made at the time of service.
OFFER PAYMENT OPTIONS:
With an increasing number of industries incorporating card payment and internet payment, these payments modes will help the healthcare facility in quicker claim reimbursement especially with the patients that have high deductible health plans. A timely follow up with a phone call will assist in determining what should be done regarding the payment.
OUTSOURCE MEDICAL BILLING AND CODING AGENCY:
When you plan to hire a Medical AR specialist, you won’t be just hiring “an AR specialist but a medical billing specialist, medical claim denial specialist, AR resolution and collection specialist, patient collection specialist and medical patient collection specialist. Instead of hiring for different designation, why not outsource a proficient medical billing and coding agency like Medphine, which has a dedicated team of all these above, making sure your AR always remains well-organized, and your healthcare practice works efficiently.