Successful medical billing requires a well-coordinated approach and meticulous attention to detail. One of the most critical factors that directly impacts the financial health of healthcare practices is accounts receivable (A/R). A/R follow-up is the process of diligently tracking and resolving outstanding claims and unpaid balances with insurance companies and patients. In a healthcare organisation, the accounts receivable follow-up team is in charge of monitoring refused claims and reopening them to ensure maximum recovery from the insurance companies. Handling the A/R follow-ups requires billing professionals with a specialized skill set.
Understanding the importance of A/R follow-up and implementing efficient strategies is paramount to thriving in today’s evolving healthcare industry. In this article, we delve into the world of A/R follow-up, the steps involved and why It is so crucial in medical billing.
Steps of A/R Follow-up
The process for A/R generally follows the following steps:
Stage 1: Initial Evaluation
In the first stage, the claims indicated on the A/R aging report are identified and analyzed. The team examines the provider’s policy and determines which claims should be deducted from the total.
Stage 2: Analysis and Prioritizing
This phase begins when claims are recognized as uncollectible or when the carrier has failed to pay at the negotiated rate with the healthcare provider.
Stage 3: Collection
After verifying all relevant billing information, including the claims processing address and compliance with other medical billing regulations, claims that are determined to be under the filing limit of the carrier are refiled. Patient bills are prepared in accordance with client specifications when posting payment information for outstanding claims is complete, and patients are then followed up with regarding payments.
These stages might overlap or not be the same for every organization. The most crucial thing is to complete the process and, ideally, receive payment of the outstanding debt, whether in full or in part.
Importance of A/R Follow-up in Medical Billing
If there is no proper A/R follow-up, it might be detrimental to the practice. Unpaid invoices due to technological difficulties might snowball and undermine the current level of confidence in the healthcare industry. In medical billing, A/R Follow-Up is crucial because:
Financial Stability
Healthcare practices healthy cash flow in order to be financially stable. The hospital’s A/R department makes sure there is a consistent flow of funds coming in to pay bills and offer patient care services.
Claims Denied Can Be Followed Up
When your claim is denied, you can submit a fresh claim request with all necessary modifications before you even receive the written denial in the mail, depending on the cause of the denial. The A/R team can ensure that all claims are remedied as quickly as possible by contacting the insurance company and asking why they refused your claim rather than waiting for your printed denial detailing the reason through the mail. Resubmitting the claims up to 7 days early rather than waiting for the mail will speed up the processing of your payments.
Claims Never Go Missing
Failure to file a claim is one of the biggest reasons for payment delays. The insurance company doesn’t always get all of the claims that are submitted. This typically occurs after paper claims are delivered but, along the route, are lost or misplaced. This problem is solved with the help of electronic claims. If the claim is not promptly investigated, it may be weeks or longer before your company learns that the insurance company never received your claim. Allow 10 working days to pass after filing a paper claim before calling the insurance company to inquire about its receipt.
Recovering Overdue Payments
A/R follow-up allows practices to easily recover past-due payments. Healthcare providers are more likely to receive reimbursements on time when a team is actively involved in the claims follow-up process.
Minimize Time for Outstanding Accounts
A/R follow-up reduces the amount of time that accounts are permitted to remain unpaid. The group monitors unpaid accounts, determines the best course of action to take to secure payment, and puts those methods into practice.
Recover Claims Kept Pending for Information
A/R follow-ups also help all practices easily recover late payments. Receiving payments on time becomes stress-free for the healthcare provider when they have a team that can actively participate in the claims follow-up processes. With A/R follow-up, you can resubmit the claim with the necessary details to get reimbursed for past-due payments.
Conclusion
The significance of A/R follow-up cannot be overstated, as it directly impacts the financial health of healthcare practices. By diligently tracking and resolving outstanding claims, providers can maintain a steady cash flow, reduce the risk of revenue leakage, and enhance overall revenue cycle efficiency. Moreover, timely A/R follow-up is crucial for addressing potential billing errors, denials, and rejections promptly, thus preventing delays in reimbursements and improving the patient experience. By leveraging technology, streamlining workflows, and investing in outsourcing your revenue cycle, healthcare practices can enhance their A/R follow-up efficiency. Implementing comprehensive revenue cycle management solutions and conducting regular staff training ensures that billing teams stay ahead of the game.
CareCloud’s revenue cycle management solutions help practices take their A/R game to the next level and allow them to increase their revenue.
