A/R & Denials Management
What Are Accounts Receivable? Accounts Receivable (A/R) represents funds owed to healthcare providers for services rendered to patients. This includes pending payments from insurance companies, patients, or other responsible parties. A/R management encompasses activities like re-filing corrected claims, identifying denied or unpaid claims, reducing AR aging, and resolving aged receivables.
Navigating the intricacies of payer contracts and handling the growing number of small-balance claims presents a formidable challenge for many practices.
Revenue Cycle Rx with a dedicated A/R team specializes in assisting you in navigating these intricate payer procedures, leading to enhanced net revenue and improved yield performance.
Accounts Receivables (A/R) that have significantly overdue payments are promptly addressed, in addition to effective denial management, which greatly influences your financial health. The primary objective of Accounts Receivable management is to enhance cash flow within your practice by shortening the collection period and reducing associated expenses.
Significance of A/R Follow-Up: Our Accounts Receivable follow-up team is responsible for investigating denied claims and pursuing maximum reimbursement from Payers.
A/R follow-up management plays a pivotal role in the medical billing process for several reasons:
Timely Settlement of Outstanding Balances: The primary objective of A/R management is to minimize the duration that accounts remain overdue. The team tracks unpaid accounts, devises effective strategies to secure payment, and ensures follow-through.
Sustaining Financial Well-Being: Maintaining a positive cash flow is crucial for the financial viability of healthcare providers. The A/R department ensures a consistent cash flow to cover expenses and support patient care services.
Prevention of Missing Claims: Delayed payments often result from claims not being received, especially in cases of paper claims being misplaced. Utilizing electronic claims submission helps prevent this issue. In cases where claims haven’t been received, prompt follow-up facilitates reissuing claims.
Resolution of Pending Claims: Some claims may remain pending due to missing information required from the patient. By adeptly following up, the A/R team can notify the patient, expeditiously address the situation, and advance the resolution process.
Retrieval of Unpaid Payments: A/R follow-up aids practices in effortlessly recouping past-due payments. Having a dedicated team involved in the claims follow-up process streamlines reimbursement for healthcare providers.
Dedicated Management of Denied Claims: Depending on the reason for denial, a fresh claim request with appropriate modifications may be necessary. Instead of waiting, the A/R department proactively ensures that all claims are pursued to resolution by communicating with insurance providers and understanding the reasons for the denial.
Significance of Denial Management: One of the critical aspects of Revenue Cycle Management is identifying claim denials promptly. Our team possesses the expertise to determine the cause of claim rejection and resubmit claims promptly. Additionally, they analyze denial patterns and devise specific strategies to reduce future denials.
