9 Nov

Effective Insurance and Patient AR Follow-Up

Medical BillingMany practices have their rejections and denials follow-up down to a fine art. But many may be leaving money on the table with their insurance and patient AR follow-up practices. Consider the following questions:

  • How effective is your practice at collecting patient balances? Insurance balances?
  • Do you have AR > 90 days less than 20%?
  • Do you know how many denials are received per week? How many are worked?
  • Do you have productivity goals in place for every department: billing, posting, and AR followup by employee?
  • Have tools in place to monitor this productivity?
  • Have reporting in place that ensures all outstanding claims and patient balances are worked at least every 30-45 days?

Patient Collections

The first step to effective collections starts when your patient walks through the door. With the shifts in high-deductible insurance plans over the last few years, it is imperative to collect from your patients at check in, rather than check out. A report from Athena Health states that “your chances of collecting payment are reduced by 62% once the patient leaves the office.” This may mean a shift in workflow for your registration, as well as your checkout staff. Sit down and plan out the new workflow and retrain the staff accordingly.

Likewise, make sure you are sending monthly statements and have a collections escalation process in place to get bad debt off your books in a reasonable time frame. Your collections escalation process can vary based on state bad debt collection laws. At a minimum, you should make sure the patient has received 3 statements, 1-2 collection letters, 1 collection phone call and a final notice before sending to an outside collection agency. Check your local laws and adjust as necessary.

Insurance Collections

The next step is to collect on insurance claims before the claim hits 60 days. Due to timely filing limits, the chance to collect on that claim reduces the longer the claim ages. Also, make sure your AR follow-up staff knows the timely filing limits of their major payors and prioritize accounts accordingly. Accounts should be worked based on timely filing limits, oldest dates with highest balances first.

Reporting

Reporting is also vital to this process. Make sure you are able to pull reports to determine both your patient and your insurance AR > 90 days to determine where special projects need to be done to collect before it’s too late. Also be sure you are tracking your aging buckets weekly to ensure your staff is focused on the right accounts for the highest cash impact.

These are just a few steps to effective insurance and patient AR follow up. Legacy can help fill in any gaps in your process with our customized solutions. Contact Us today!

Comment below to share your AR follow-up successes or challenges!

Donna White

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