One of the factors that tell you RCM optimization has to be done immediately, is the high AR.
Let’s find what is really happening with the AR. Why the files keep piling up can be due to various reasons.
Lack of Analysis
When patient AR keeps mounting up, higher chances are there the front desk is not functioning properly. Ensure, your financial policy is made clear to the patient at the point of service.
Ensure all the claims are submitted on the day of service. This can bring down the delays, denials, and rejections. It is not the fact that all the providers have resources to manage claims.
Opting for outsourcing claim processing and AR calling can help a great deal. Professional agencies deal with end to end services, and ensure faster payment.
When the problem is with the in house team, or the staff, who cannot manage AR and claims processing effectively, outsourcing is the most efficient technique.
Claim denials get less focus
To ensure the cash flow is positive, the claim denials should be maintained below 5%. The industry average of claim denials in US is 5 to 10% as reported by the American Academy of Family Physicians.
Denials can happen for numerous reasons, from the incorrect codes to missed payer deadlines. It becomes evident that staff should be educated to deal with errors even before the claim is submitted.
When errors are because of payers, and medical necessity, analyzing them frequently can bring down AR days.
When your staff fails to understand the importance of identifying coding errors, it is simple for anyone to find why the claims take long time to get paid.
Well-trained staff is the first step to bring down the AR days of claims. Your staff must begin with verifying the insurance, educate payment policies to the patient, and line up patient collections.
Staff who know the importance of patient collections can only help in reducing AR days.
Ensure patients pay at the time of service, and patient billing information is updated at the time of the visit.
Financial policy in place can reduce the issues to a great level, and analyzing the financial report once a month can be greatly helpful. Your staff should consider this a part of the performance.
Worry-free about write-offs
Failing to keep track on contractual write-offs can also lead to longer AR days. Maintain a reimbursement schedule for each payer, and track the same.
This ensures your claims are paid on time, and there are no unwanted write-offs.
Filing the claim after the deadline, errors in administrative process and writing off debts can only mean your AR days are long.