Prosperis Pays Great Attention to AR Management

Efficient accounts receivable management in healthcare organizations is crucial for maintaining a stable cash flow, optimizing revenue, and ensuring financial sustainability. It requires expertise in healthcare billing regulations, coding practices, payer requirements, and effective communication with patients, payers, and internal stakeholders.

Services

• Accounts Receivables (AR) follow-up in a healthcare organization involves the systematic process of monitoring and pursuing outstanding payments for services provided. It ensures that claims are processed, paid, and resolved in a timely manner. Here are the key steps involved in AR follow-up:
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• Claim Submission Tracking: After claims are submitted to insurance companies or government payers, we track the status of each claim. This involves monitoring the progress of claims through various stages of processing, such as claim received, under review, paid, denied, or pending.
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• Claim Denial Management: When a claim is denied, we begin by identifying the reasons for denial. This may include reviewing the explanation of benefits (EOB) or remittance advice received from the payer.
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• Appeals and Resubmissions: In cases of claim denials, our AR follow-up process includes preparing and submitting appeals to challenge the denial decision. Appeals may require providing additional documentation, clarifying coding or billing details, or explaining the medical necessity of the services provided. Resubmissions involve correcting errors or omissions in the original claim and resubmitting it for reconsideration.
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• Payment Posting and Reconciliation: Once payments are received from insurance companies or government payers, we accurately post the payments to the corresponding accounts. This step ensures that the payment is correctly applied to the outstanding balance and reconciles any discrepancies between the expected payment and the actual payment received.
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• Accounts Receivable Aging Analysis: Regularly analyzing the aging of outstanding accounts receivable. This involves categorizing accounts based on the duration of outstanding balances (e.g., 30 days, 60 days, 90 days or more) and evaluating the collection performance. Analyzing aging helps identify overdue accounts, prioritize follow-up efforts, and determine the effectiveness of the organization's AR management strategies.
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• Patient Billing and Collections: In addition to working with insurance companies or government payers, we also manage patient billing and collections. This includes generating patient statements, communicating with patients regarding their outstanding balances, setting up payment plans, processing patient payments, and addressing patient inquiries or concerns related to billing.
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• Communication with Payers and Patients: Effective communication with insurance companies, government payers, and patients is essential in AR follow-up. This involves addressing inquiries or disputes, providing additional information or documentation as needed, and maintaining open lines of communication to resolve outstanding payment issues.
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• Documentation and Reporting: Throughout the AR follow-up process, we document actions taken, communication with payers or patients, appeals filed, and any other relevant information. Additionally, we generate regular reports on AR aging, collection rates, and overall financial performance helps identify trends, measure performance, and guide decision-making.

What You Can Expect from AR Management

You can expect an experienced team in healthcare billing and collections, streamlined processes, efficient claims submission and follow-up, increased revenue collection, reduced accounts receivable days, improved cash flow, enhanced payer communication, comprehensive reporting and analytics, and adherence to compliance and regulatory requirements.

Schedule an Appointment

Contact Prosperis Consulting today for a complimentary consultation regarding AR management needs. Ensure the success of your medical practice with help from our professional team.