Aging AR
Clean-Up

When AR volume has exceeded the capacity of your team to address issues, AR will build up. Once this happens, workflow strategies have to be deployed to prioritize volume and increased capacity needs to be calculated and brought to meet the timeline of a project. This starts with analyzing AR Aging reports for bulk issues, write-off vs payable clean-up efforts, claim volume vs. dollar volume, etc.

Denial
Follow-Up

There are hundreds of reasons why a claim could be denied. Staffing knowledgeable team members who can correctly diagnose the root issue, and take the appropriate follow-on action is important. This can include appealing the denials or sending a correcting claim (among other actions). Having an AR process that can scale is a safeguard against being inundated with denials that aren’t worked timely, and eventually have to be written off for exceeding timely filing deadlines.

No Response
Follow-Up

When we do not receive a response – either a payment or denial – we follow up with carriers to understand what went wrong. Every carrier can have their own processing time, therefore it is important to track those closely to avoid any premature follow up. Effective follow-up can identify lost claims, or lost payments and denials. Efficiency is central to avoid lost revenue through timely filing delinquency.

Credit
Balance

Insurance carrier mistakes or delays can result in practices erroneously shifting the financial responsibility of a service to a patient. In time, if root issues with a claim are corrected, or the carrier subsequently processes a payment, the practice could be in the position to have been paid twice for the same service - once by the carrier and once by the patient. The practice has a legal responsibility to work these accounts, and issue a refund to the appropriate party, we can help with this analysis and the subsequent work effort so that credit balances don’t spiral into a compliance liability.

Benefits
Verification

Prior to a patient visit, we can support the practice by verifying that anticipated services will be covered by their insurance policy. We do this by reviewing carrier websites and/or calling carriers directly if we estimate that all available online information is incomplete or misleading.