Looking for maximized collections ?
According to a recent survey by MGMA, most medical practices are going unpaid for 25% of the services they render to the patients.
If your medical practice is experiencing such hiccups, this is the “must read” blog for you.
From the Bottom…
Though Accounts Receivable (AR) is not a new term for you, I’ll start this blogging from the scratch. AR signifies legally imposable claim for payment to your practice by the patients or insurance payers for the services delivered by you to your patients. Despite this generalization, AR management strategies must be payer-specific (for reimbursements) and patient-specific (for co-pays, deductibles, etc.).
The Stats Signal
It’s the time to wake-up ! The American medical practices are under the juncture of transformation from just billing for the rendered services to billing and dogged collections management.
- According to report furnished by the Centers for Medicare and Medicaid Services (CMS), only 70% of the medical claims are reimbursed the first time on submission.
- Rest of the claims (30%) is either denied (20%) or misplaced or unnoticed (10%).
- 18 out of 30 claims are not resubmitted to the insurance payers making a voluminous loss for the practices.
The Best AR Management Practice
Here is the Presentation on the state of the art collection strategies
Streamlined automation
Streamlined automation of your revenue cycle management (RCM) is a crucial mode to recoup your ARs.
Thwart potential denials
Thwart potential denials well before the claims submission, so that your claims will be reimbursed right at the first time.
Intelligent engine:
- You could install the feasible software in need at your practice for improving your denial prevention rates and maximize the collections. Besides, business intelligence and analytics tools enable you make better decisions, perk-up productivity and catch underpayments and curtail collection delays.
First-pass resolution rate:
- Improve the scrutiny of your medical bills through software and expert support before submission to accomplish higher first-pass claim resolution rate. This would drastically mitigate the workload of your practice staff and enhance your claim acceptance and further collection rate.
Contract negotiation and management:
- Many practices fail to verify the difference between actual payment and the payer’s contract value. Automated reconciliation of these values aids increased reimbursement and better budget forecasting.
AR Aging:
- 30/60/90 days aging report model is becoming outmoded. If Medicare is ready to pay you within 14 days and if you follow the payment after 30 days, that’s a clear loss for you. Thus, daily AR aging report and follow-up is very essential for faster collections and improved productivity.
Workflow optimization:
- If there is a barricade in your collection process, the gap between the time of service and the time of collection would be prolonged which culminates in loss. To overcome this glitch, automated e-mails to the management or superior authority and instantaneous remedial action can be yield better results.
ERA accuracy:
- Cross-examine the ERAs against payer contracts for the accuracy of payment details.
Special routing and tracking:
- Payer-specific collection experts and queue-based collection assignments can be set in an organized manner to follow claims, denials and payments.
