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How to overcome the shortcomings in Accounts Receivables management

Business

Healthcare, like any other business, connects directly with its customers to inquire about and collect unpaid amounts. Now that the number of physicians and their services is increasing rapidly with the increase in patient influx, healthcare practices find it really difficult to follow up on huge chunks of unpaid revenue due from both patients and insurance companies.

Practolytics’ AR team provides services that best solve all these AR-related issues, along with AdvancedMD, the world’s largest providers of cloud-based software offering an all-in-one EHR and practice management solutions.

AR Calling

Accounts Receivables Calling, or AR Calling, is a team of dedicated staff who help medical practices, clinics, or any healthcare organization overcome issues associated with the pending revenue receivables from payors. These services are typically outsourced to billing companies who have the required expertise so that healthcare organizations can carry out their day-to-day priorities smoothly, and not have the burden of following up with insurance companies.

Most healthcare organizations completely rely on outsourced billing companies to overcome their AR issues. The AR calling team is also responsible to manage denials from insurers that could lead to maximum reimbursements. Initially, the AR callers were a part of the healthcare organization itself, as in-house staff. However, AR calling requires a special set of skills to recognize patterns and follow up diligently to identify the bottom-line issues. Let us look into major operational issues with AR calling, and the ways to overcome them.

Accounts Receivables Calling: Key Operational Problems and Solutions

1. Lack of knowledge of the process

Issues related to AR calling demand corrective actions to be carried out, especially in case of denials. There could be multiple issues associated with AR denials.  One must have a deep understanding of the entire claim lifecycle process to identify the underlying issue. They must be thorough with all the information that is related to all the insurance accounts.  A well-skilled AR caller need not go about multiple calls to resolve the same issue as it exhibits a lack of confidence in handling AR claims.

Solutions

  • Assign callers to certain insurers or doctors to prevent confusion over the protocols being followed.
  • Make sure your callers are paying close attention to the call to prevent needless repetitions.
  • Integration of call tresses based on denial reasons can result in unified documentation and fill in gaps in information capture.
  • In circumstances when the payer does not offer initial claim status via phone, ensure that the callers assess the claim and send it back to web follow-up teams.
  • Periodically review the call logs that your callers have created.
  • Regularly examine your A/R data so that you can learn a lot about your team’s productivity from it.

2. Call Documentation Gaps

Notes during calls must be taken down precisely and documented in a well-structured manner. If callers fail to document them correctly or if delays occur in documentation, this will lead to an ineffective process, missed patient details, and misdialed numbers. This will in turn have a negative impact on the corrective actions to be taken while resolving payment issues.

Practolytics utilizes the AdvancedMD practice management software that helps to align all the calls in a standardized manner to avoid any gaps in documentation.

Solutions

  • Employing direct queries and call flow software guides callers to gather the appropriate data for particular denial coders.
  • For each AR-related problem, operational executives should consider automation possibilities in call documentation standardization through automated documenting capabilities.
  • Call recording systems to provide a great way to find or double-check missing information.
  • Regularly train your callers to adhere to the team’s documentation procedures and processes that are appropriate for your billing organization.
  • Regularly evaluate the calls and the data your callers have gathered.

3. Significance of Call Ethics

The major ethics associated with AR calling is to maintain a neutral tone with a well-balanced display of hospitality while having conversations with the payers.  Several times, the callers have been pointed out to be impolite and rude behaviors with the insurance representatives. This is a big no under AR calling ethics.

AdvancedMD Billing Services when combined with the expert skillset at Practolytics helps to maintain strict and effective adherence to all the AR calling ethics.

Solutions

  • Callers should always be kind and professional when speaking with payors and patients.
  • When on a call, the caller should make sure their surroundings are quiet.
  • The callers should speak to the patients and payor representatives clearly, in a very kind yet neutral tone.
  • All callers should be evaluated based on the volume of work. Remedial training can reduce mistakes and enhance collections.

Outsource your Accounts Receivables to Practolytics’ Expertise

Handing over your AR workloads to medical billing professionals like Practolytics will bring increased collections via structured AR process management. Our partnership with the AdvancedMD EHR solution has helped gain trust among several healthcare practices across the country, not just for our partnership, but for how well our collaboration has assisted medical practices to attain revenue success without having to compromise on their primary goals. Our AR team consists of experts with comprehensive skill sets in the healthcare domain along with excellent communication skills. We adhere to a strict auditing procedure and work hard to maintain a very low error percentage while significantly enhancing collections.



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Practolytics
Practolytics partnered with AdvancedMD in 2013 to create a one-stop solution for all the medical billing, practice management, patient management, and revenue cycle management activities a healthcare practice need to carry out. A Platinum partner amongst 850+ billing companies, Practolytics is a 20+ year-old healthcare technology and revenue cycle management services company providing medical billing service solutions to 180+ practices of all sizes spreading across 31 states and serving more than 28 critical specialties. Practolytics with support from AdvancedMD billing software processes more than 2.5M claims annually, collecting more than $500M for its clients. End-to-end services include medical billing, medical coding, chart audit, credentialing, eligibility, benefits verification, and preauthorization services. The company’s diverse background in every aspect of healthcare allows it to maximize revenue and consistently deliver optimum results.

Topic: Business, Medical Billing


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