AR follow- up management: Essential in the medical billing process

AR follow- up management: Essential in the medical billing process

You must be aware of the Accounts receivable or AR in medical billing. However, AR follow up is also essential in medical billing to fetch the money for practitioners.

AR Follow-up team has a significant role to play in every healthcare organization and also, this team is responsible for looking after denied claims and reopening them to receive maximum reimbursement from the insurance companies.

Why A/R Follow-up is Important in the Medical Billing Process?

Proper A/R Follow-up management is important for in the medical billing process, why? Let’s discuss some general reasons

Financial stability of healthcare organization

Positive cash flow is directly proportional to financial stability for any healthcare organization. These healthcare organizations need to maintain a steady flow of revenue to cover expenses that provide patient enhanced care services.

The claims never reach to the insurance company

If the paper claims are getting lost in midway before they reach the insurance companies then such claims are not getting filled to an insurance company. Quick follow-up can aware of your firm that the insurance company never received these lost claims.

Analyzing claims for collection

AR management mainly deals to reduce the time of outstanding balance for a particular account. Moreover, The AR follow up team performs various activities such as analyzing various accounts that are having outstanding balances, look for appropriate action to secure payment, and implements procedures for secure payment.

Corrective actions to resubmit claims

There are various reasons for claim denial. Now, this team analyses the reasons for claim denial and take proper measures to correct it and submit the denied claims again. Moreover, the A/R team can ensure that all claims are followed through until the end.

Recover claims which are pending for information

It is observed that claims are getting delayed due to additional information needed for the member. Proper following –up enabled the A/R team to aware the member about the situation and then opt for suitable action to speed up the process.

After the “WHY” for AR Follow-up, we need to consider the phases of medical billing AR follow up.

Steps for Medical Billing A/R Follow Up

A/R follow- up must be carried out in an extremely systematic manner which is conducted in the following phases:

Initial assessment of medical A/R follows up

During this phase identification and evaluation of all claims registered on the aging report are done. The AR follow up a team now look provider’s adjustment course of action which helps to identify the claims that can be adjusted.

Analyzing issues with claims

In this phase team analyses the various issues of claims that are marked as uncollectible or claims where the insurance carrier is yet to pay according to its contracted rate with providers.

Moreover, the appeal/filling limits of the key carriers will be checked as well as claim address is verified so that it will reach the ideal processing unit.

Collection from medical A/R follows up

Now this phase is crucial and various activities are carried out based on Analyzing issues with claims

  • Claims are refilled if they are within the appealing/filling limit of the insurance carrier with properly validating all the needed billing information
  • Some claims are appealed to the essential supporting documents. These claims are mostly underpaid by the insurance carrier. This appeal process depends on the plan, state, and insurance carrier.
  • Now, claims are electronically transmitted directly to the insurance carriers and in the case of other carriers, claims are forwarded with the help of clearinghouses. Now, these claims are aggressively followed by the insurance carrier for confirmation.

Nowadays, due to complex medical billing and pilling up of denied claims, the healthcare organizations demand billing specialists who are having a dedicated skill-set to look after your organization’s A/R follow-ups.

Need for A/R team who can follow-up claims

Apart from AR, there are various procedures such as payment posting, verification, and charge entry that needs to get completed first. During these procedures, a medical billing specialist determines the exact procedure code and diagnosis code based on the treatment plan. Still, there are chances that the insurance company will deny claims if they don’t adhere to the rules, therefore it is critical to have a dedicated A/R team who can follow-up with the insurance firm to resolve denied claims.

Healthcare providers are facing various challenges such as long receivable cycles that delay the revenue, fatigues of the billing teams frustrate the financial management, and destabilizes the cash flow. However, just by outsourcing account receivable follow-up services to an experienced service provider, you can be focused on your competencies and also, your business can overcome these challenges.

Our experienced and certified A/R specialists has worked with various insurance companies and is well-versed with their policies. We make sure that our clients should not have any difficulty in collecting their service amount from insurance companies. Connect with our AR specialist today to collect all your old AR.

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