In the healthcare industry, physicians run tests and analyze results to help diagnose a patient. An A/R analysis can work the same way by offering ways to identify and ultimately repair the billing processes in your practice.
Practices often see the following A/R problems:
Failure to adequately use technology. Whether it’s an EMR or a practice management system, staff members often fail to get the most out of their computerized technology.
For example, practices might not load managed care reimbursement rates or fee schedules by CPT code into the system. Many also fail to load payer-specific edits.
As a solution, practices should research vendors that provide an electronic interface to access the practice’s payers and download updates. This gives practices the convenience to send out a request to the payer providing the most current insurance information before the patient arrives at the office, helping to avoid a denied claim and saving time.
Failure to bill the correct insurance company. For example, a patient has two insurance companies: a primary and a secondary. The staff member makes the mistake of billing the private company first and then sends a bill to Medicare, which means both bills are in the mail at the same time. Now the office will have to resubmit the claim after receiving a denial statement in the mail.
Failure to track and collect patient payments. Often, the billing department does not give patients a specific time to submit their payment to the office. They do not send out notices in the mail that explain the practice’s collections policy. This may cause confusion regarding what services a patient’s insurance provider will cover and may prevent patients from paying altogether.
These common pitfalls can result in lost time, increased A/R days, and reduced cash flow, says Frank Cohen, a senior analyst at MIT Solutions, Inc., in Clearwater, FL. But establishing an A/R analysis at your practice as a standard task not only can reduce billing mistakes, it can also help staff members recognize and avoid these problems altogether.