If you don’t revisit your processes and procedures for Accounts Receivable regularly, they can easily get out of hand. Your practice is collecting from thousands of patients and potentially dozens of payers - and without regular maintenance, your A/R won’t stay a well-oiled machine for long.
Working with a medical billing service is one way to keep your A/R running smoothly, since an outsourced firm will have the resources and knowledge necessary to help you keep your payers paying and your patients out of collections. If you’re not ready to take that step, however, there are several things you can do to make your A/R efforts a lot less messy - and we suggest you start now!
Get the 360 View
Before you can optimize A/R operations, you have to get a handle on the situation at hand. Run every report possible via your medical billing or practice management software to get an overview of payment timing, denials, first-pass resolution rates, and everything else you can. (The more knowledge you have, the better.) Assess the data for problematic trends or issues.
Ideally, you’d use the intel from your 360 review to make an action plan for overall A/R improvement. But to keep your practice from getting overwhelmed with A/R, it’s best to decide on three key issues and resolve to address them promptly in a set period of time - say, 90 days. For example, pick three payers for whom you have a high rate of denials, and set the goal of lessening denials by 2-3 percent for the coming quarter.
Learn the Rules
Make it mandatory for your billing specialists to know each payer’s filing deadlines and recommendations for submitting clean claims the first time. (Quiz them if you have to!) Understanding payer-specific requirements is the easiest way to get your first pass resolution rate above 90 percent and avoid lengthy follow-ups as you chase down payments.
Make a Contact
The best way to get your issues with any payer resolved is to get the help of a point person who already knows you. Do you have one with each payer? Reach out to the provider relations department of each of your contracted insurers and ask who the local representative is in your region. Consider scheduling an in-person meeting with the rep to get acquainted and open the lines of communication.
Get Firm With Patients
Outstanding co-pays and patient balances are likely stunting your revenue. Taking a hard line with patients isn’t just smart - it’s necessary to the health of your business. Make it mandatory to collect co-pays up front, prior to the patient encounter. For other balances, send three statements to a patient before delivering a 15-day demand letter. After that, send them to collections or cut them off before they can do any more damage to your bottom line.
...and if you need help with your practice revenue...