Are you suffering from recurring errors in your Medical Account Receivable processes? It’s important to know that you are not alone, as there are many common problems that trouble healthcare organizations and obstruct their financial goals.
Unpaid accounts receivables can seriously damage your cash flow. It is the most critical process in any business. The main reason is poor AR management might result in unhealthy cash flow, and it is hard to manage AR.
In this way, you must employ the correct processes and tools for overcoming the challenges.
Throughout this guide, you’ll learn about 4 common challenges for accounts receivables and how to solve them.
Let’s have a look!
Problems Relating To Accounts Receivables Management & Solutions
1. Knowledge Deficit
It is crucial to have a deep insight into the multiple reasons for claim denials or delays in payments. However, these problems must be corrected. Providing particular information regarding insurance claims, treatments, or delays is one way to help in implementing these measures.
The lack of follow-up leads to countless requests for the same issue, which shows a lack of confidence in claims resolution. There is always a solution for any problem. Check out how you can resolve it below.
- Train your calling team on a regular basis.
- To prevent confusion in the protocols, assign callers to specific insurances or physicians.
- You should make sure your callers pay heed to the call to prevent excessive repetitions.
- Embedding denial reasoning can simplify call documentation.
- Callers should review the claim and route it back to the web follow-up team for cases when the payer does not respond to initial claim requests by phone.
- Audit the call notes your agents have written frequently.
- Keeping an eye on your A/R data can help you better understand how efficient your team is.
2. Call Documentation Is Incomplete
It is best to document call notes in a structured manner, either during the call or immediately after. When A/R team members document call notes late, ineffective documentation is generated, and dialed numbers and insurance information are missed. These issues result in ineffective corrective actions that further delay the recovery and payment.
- Through the use of objective questions, the caller is guided to gather the right information for specific denial coders (kick codes).
- In order to standardize call documentation, operations leaders should consider automated documentation capabilities for each of the issues listed above.
- An excellent way to retrieve or cross-check missing information is using call recording technologies.
- Make sure your callers consistently follow your company’s documentation protocol and billing process.
- Your callers’ calls and collected information should be regularly audited.
3. Denied Insurance Claim
The healthcare organization’s cash flow is negatively impacted by this predictable and frequent AR problem. It is estimated that the denial rate for healthcare is between 10% and 25%. Despite this, MGMA recommends that the best healthcare organizations have a denial rate of only 4%.
By making simple corrections, you can avoid the significant loss of revenue due to your hospital or organization.
- The medical accounts receivable management team must carefully review each claim form before submission so that it meets the guidelines.
- All denied claims must be investigated and any missing values must be determined and submitted.
4. Unnecessary Write-Offs
There are some write-offs that are important, and others that do not. You should review each medical account receivable carefully. It is unlikely that the team emphasizes a lower payment amount, but some patients opt to pay in installments.
Ultimately, these small payments will have a negative impact on your organization’s balance sheet if they are not managed properly. Consequently, you must remember that a quick review of the patient’s every overdue bill could lead to reimbursement for your organization.
- Determine which write-offs require managerial approval. These will help you to accelerate smaller accounts.
- Monitoring and tracking write-offs will allow you to identify issues with your reimbursement policies and procedures. Using tracking, you can identify the problem associated with higher spikes.
- The first step towards reducing unnecessary write-offs is to identify and devise a plan. If you want to create a successful strategy, you need to examine the past data and determine an average write-off rate. Setting a limit for annual write-offs will give you control over them.
5. The Staff Is Unmotivated
Everyone in your organization, from medical providers to administrative staff, should love what they do and should strive to help your organization reach its mission and objectives.
The bottom line is that if your organization is losing money both on the salary side as well as on the profit side because of a lazy staff, then you should observe the negative impact on the organization’s account.
It is highly recommended that you outsource revenue cycle management and receivable management operations to a reliable outsourcing partner, who can diligently implement your requirements with the latest technology and dedicated staff.
Outsourcing RCM services has many advantages that your organization can compare to hiring in-house staff.
Managing various tasks at once in the healthcare industry is not easy. A top priority of today’s health organizations is to reduce costs and improve efficiency. So, if you are considering outsourcing your revenue cycle management and accounts receivable tasks then it is the best solution for all your healthcare needs.
We at Med-Miles LLC follow a strict audit process to improve your collection process. To learn more visit our Accounts receivable Management services