Importance of Old AR Recovery in Hospital Financial Performance
Accounts receivable are the primary source of un-received revenue for your hospital or medical group. Most hospital leaders and CFOs focus less on old accounts receivables as they are labeled as not collectible and written off as bad debts resulting in poor collections and overspending of the incorrect billing and staff who does it. These are a few reasons why working on your hospital’s old AR recovery is worth more than you think.
Staff expertise:
Accounts receivable (AR) is usually performed by the same staff who does the entry-level aspects. They might not even be certified coders to analyze the procedures before submitting the claims. Since they lack the expertise and usually focus on the current tasks for performing daily charge capture, entry, and claim transmission process, they will have only fewer hours to sort out the old AR and take reimbursable action against it. This is why working on your hospital’s old AR recovery is worth more than you think, Piling up these unpaid claims over a period of months will be estimated at around 20-40% of the net billable charges.
If this issue is persistent over a few months then you will be looking at around $100K worth of unworked old AR sitting on 90 and 120+ buckets that are then sent to collection agencies where they even charge a certain percentage of the collectibles as their fees resulting in very less ROI to your hospital. Having certified Accounts Receivable (AR) staff will reduce AR days within 30 days. The reason is that AR specialists with 5+ years of experience can actively concentrate on the root causes of these unpaid old AR claims and find a solution to prevent them from ever happening in the future.
Global or bulk issues:
The term “Global issues” is usually referred to as global days for surgeries, but usage of this term in AR are issues that cause most unpaid and denied claims. Some even call it “bulk issues” as the cause for insurance companies not paying the billed charges. Bulk or global issues exist when only contracting lapse, credentialing updates, other specialty code usage, or not following revised guidelines by CMS and other federal healthcare institutions.
It is because of these constant threats that working on your hospital’s old AR recovery is worth more than you think because bulk/global issues need more analysis time rather than correcting claims. If your hospital has experienced AR analysts who can backtrack these issues from the origination point, then the odds of recovering the money that has not been paid by the insurance company will be increased double as solving these global/bulk issues will prevent any more claims denials or non-payment in any future billing involved with that particular provider or specialty.
Clearing house transmission problems:
Usually, an in-house billing staff does not concentrate on clearing house rejections and transmission resulting in 100s unattended and unresolved claims stuck in the clearinghouse end. The other aspect of a clearing house is payer ID, as discussed in the previous section a single-payer has multiple plans and the billers need to identify the correct payer plan and submit the claims. If the payer ID is incorrect the claim tends to be rejected at the payer end and no further response will be received.
So constantly verifying clearing house transmissions will keep unattended claims at bay and remove incorrect payer IDs that will reflect positively in your AR thereby increasing the chance of clean claim rates and reimbursements.
Solutions to reduce AR:
The Healthcare industry has invested a lot of capital to implement technology solutions that can drive the RCM process successfully. Automation systems are so sophisticated nowadays that they can mimic human staff performance, such technology is created by BillingParadise for each RCM process including AR.
Robotic Process Automation in AR:
Hospitals and medical groups that are struggling to hire experienced staff for AR analysis can opt for robotic process automation (RPA) to perform AR on a daily basis. The reason why we suggest RPA bots for this process is that they can perform AR analysis and run the next reimbursable within minutes even when there is no supervision from your billing staff.
RPA and AR
The unattended RPA bots perform these AR tasks 24/7 365 days, so each day your hospital or medical group uses RPA the more your unsolved AR and accounts receivable days will be reduced. RPA bots will also report to your designated staff on a daily basis on the claims that are worked and the pending dollar value of the current outstanding AR. Paperwork like reconsideration, redetermination, and corrected claims are automatically done by RPA bots that will reduce significant time and energy for your staff leaving them to monitor and concentrate on resolving many high-value tasks.
BillingParadise and our resources farewell experience in resolving pending and old AR. Over the years we have recovered more than $1 million of unpaid accounts receivables. Our AR staff and automation systems stand as a definitive solution for hospitals and medical groups that are particularly looking to solve the piled-up AR. Our Lost Revenue Recovery Audit (LRRA) is the first important step to solving old AR, get this free audit today and utilize it for our old AR recovery services.
