4 Tips For Accounts Receivable Management In Medical Billing

According to a report, out-of-pocket expenses have increased by 230% from what they were in the previous years. As a patient, it means our health maintenance costs have gone up and it doesn’t look like coming down any time soon. MIPS 2022 comes up with the most important advancement like always for clinicians to continue their journey with value-based services while being disincentivized and incentivized based on their performance.

Medical billing and coding teams create accurate claims in complete synchronicity with clinical functions to stay compliant with MACRA-MIPS. Hence, a billing company that is also a HIT consultancy is vital to the MIPS reporting process.

Coming back to our topic, Group One Healthsource reports that around 40% of the healthcare providers are unable to collect $31,713 from their patients every year. The reasons why they fail to collect such a huge amount are errors in documentation of medical procedures and misinformation (we can’t really misspell or mistype date of birth). Hence, accounts receivable (AR) need special attention to close the gap between the claimed amount and the received amount.

Given below are a few tips to improve the billing process for physicians and boost AR management permanently.

Focus on Error-Free Medical Claim Submissions

Late payments and claim denials usually occur due to medical billing and coding errors. The insurance companies accept only those claims that are according to their claim filing standards. The strict policies don’t have room for even minor errors.

It is important to review each claim precisely before submitting it to the insurance companies. In the case of a claim denial, you must have a professional denial management system in place. Insurance payers’ representatives can help rectify each problem efficiently.

Make the Payment Procedure Transparent

Another approach to minimize accounts receivable is to make payment procedures transparent. When physicians notify patients of outstanding medical expenses prior to the treatment, it becomes easier to collect payments. Hence, more and more claims come out of the unreceived pile onto the received shelf.

Billing companies inform physicians about the payments approved by the insurance companies and payers like Medicare and Medicaid. To maintain transparency in the medical billing system, professional medical billers verify the eligibility of the patient before submitting the medical claim. It reduces the problems in later on.

When you collect copayments earlier into the revenue cycle management (RCM) process, stop worrying about the escalating number of AR days. It also saves you from unnecessary paperwork later.

Medical billing outsourcing companies perform at crunch times, as their performance is crucial to the cash flow of physicians on their subscription lists.

Make Use of the Latest Medical Billing Tactics

Medical billing standards have changed over the years. Hence, the billing staff requires constant training and knowledge to improve their skills. It results in improved medical billing tactics for better reimbursements and reporting MIPS 2022 Quality measures to score high in MIPS.

The latest trends demand investment, but they benefit in the end. By staying up-to-date with the latest tactics, we not only reduce errors in medical claims but improve accounts receivable management as well.

Audit Medical Billing Process

By auditing the medical billing and coding of a certain practice, we may identify the problem areas creating the mess we know as accounts receivable. For instance, when there are frequent changes to patient’s information, errors have a high probability to occur. Such mistakes lead to outright denials.

Correct and timely identification of where the claims are choking the system is what companies like ours are trained to do. Such audits catch errors and breathe life into a billing system by streamlining the process of revenue generation.

Tips that Improve the Overall Billing Performance

Tip No. 1: Moving towards a Streamlined Front-Desk Process

This tip involves the performance of some typical back-end functions that can be conducted easily by the front office staff. It includes the verification of insurance eligibility, patient liability estimation, and requesting pre-authorization.

So, when these things are done by the medical billing services earlier in the billing process, it gives patients the relaxation to know their copayments beforehand of the treatment.

Moreover, getting pre-authorization upfront is really a good practice to avert rejected claims and help keep days under the control of AR.

Tip No. 2: Implementing Best Practices in Billing and Coding 

It is called a precautionary approach. If you want to minimize the time of getting reimbursement and lost revenue opportunities, you need to avoid claim delays, denials, and rejections. For this:

• 100% certified coders are required
• Use appropriate modifiers to document treatments
• Just code right; do not under code or over code
• Use specific diagnosis codes instead of non-specific codes

Tip No. 3: Manage Your Denials Effectively & Timely

Adapting the best medical billing and coding services practices will help minimize denials and rejections. However, it will not fully remove the chance of them.

So, effective and timely AR management is important to reduce your days in the AR cycle.

According to industry sources, 50% of denials are never worked again, resulting in a 5-7% net revenue loss.

• We need to create a well-defined list of CARC (claim adjustment reason codes)
• The success rate of the appeal is based on the content of the appeal. You must have an approved standard appeal template.

For the claim denials, use the preventive denial analysis. The time and effort that you invest will never go to waste, and it will also reduce your future claim denial rate.

By training the staff and physician’s financial management team, areas with glitches are more frequently identified and fixed accordingly. Soon after a claim is fixed, it gets resubmitted to the insurance company starting the appeal process. The earlier the better because then reimbursement doesn’t have to face any further delay.

Conclusion

The above-mentioned tips reduce the number of resubmissions of claims to the insurance companies. The time duration for payment collection shortens. In addition, physicians get to receive revenue in a timely manner.

P3Care’s medical billing services provide professional medical billing solutions to healthcare professionals and increase their revenue considerably via the latest billing methods.

We know that independent medical practices deal with the changing RCM policies. Managing the accounts receivable is one of the curious aspects of the healthcare business that cannot be overlooked. By implementing these tips throughout your revenue cycle, you will be able to meet your objectives while also increasing the cash flow.