Medical billing has been gaining popularity in the past few years as more and more hospitals are embracing it because of how efficacious it is. Instead of relying on the in-house staff, more hospitals are now outsourcing medical billing services since it not only puts less pressure on the medical professional but they can also focus more on their patients and get better returns for their business as well. There are many segments that form the entire medical billing team, one of them being the Accounts Receivables (AR) Management. In this article, you will get to know more about how AR plays a major role in improving the efficiency of the RCM.
What Is Accounts Receivable Management?
AR (Accounts Receivables) refers to that particular department wherein they play a major role when it comes to dealing with unsettled claims or when unpaid claims need to be handled. They make sure that the payment of the unpaid claims comes as quickly as possible from the insurance companies without any delays. If there are any problems that need to be looked into they will be thorough and find out what it is.
It is the responsibility of the Accounts Receivable in healthcare to look into whether or not a patient is in charge of any liabilities, if yes, then how much should they be charged for it? Also, it is important to remember that if the hospital is unable to bill the patient, how must the charges be handled – should they be written off or be adjusted through credit payments.
As easy as medical billing might seem, it is actually quite a lengthy and tenuous process which can take months to complete. It must be remembered that a hundred percent success that is achieved through the claim’s submission process is quite difficult to achieve, if not impossible. Outstanding payments along with the follow-ups that need to be done for the claim’s delayed payments and denied claims all form an important part of the process of medical billing. The AR specialists in medical billing are responsible for handling every part of it. Without proper AR management in RCM, denied cases and outstanding payments can increase exponentially which can cause a downfall for the hospital.
The Key Functions of The AR Department
For a hospital to function properly its AR department needs to be top-notch since they are responsible for generating the majority of the revenue for the hospital.
- Consistency in income: For any business to run properly money is a necessity. As blunt as it might seem, if a hospital is not generating enough revenue through its rendered services, then it will become difficult for the hospital to sustain itself in a proper manner. Without a proper accounts receivable management team, a lot of things can go haywire thereby restricting the flow of income altogether. This can cause a lot of problems claiming insurance. Therefore, being constantly updated with all the changes and the provisions that are being made in the health industry is always a good thing.
- Focusing on patient satisfaction: The best account receivable management service is when they focus on calling the patient and verifying all the necessary details that are either missing or have not been noted down along with discussing the dues that are outstanding. Also, no patient wants to be in the middle of documentation, medical coding and all the other aspects that are included when a patient receives treatment. The medical billing company would ensure that the medical follow-ups on the already denied cases get completed without any hiccups. A medical billing company that focuses on having a great AR team will always keep the patients happy and satisfied.
- Focus on taking the right actions for all the unpaid claims: The AR team is in constant touch with the other follow-up teams in order to get the necessary details about all the unpaid claims. The analysts of the AR department comply with all the details about the claims in order to analyze and make the correct decision that will help in fulfilling the payment.
- Researching the claims that have been rejected or denied: The AR specialists in medical billing focus on examining the rejections and carriers that could have led to the denied claims. This is an important part of their job that they perform very diligently.
Maintaining the highest value for the AR days: It is crucial to maintain good health for the accounts receivable days. This meter is useful in giving you an understanding of whether or not the health of the accounts receivable is good or bad. In order to get the correct AR days, the formula that is widely used among many specialists is: subtracting the yearly gross charges from the accounts receivable days divided by 365.
Good Practices That Make an AR Department Good
Revenue cycle management solution includes good AR department practices, let’s take a look at what those are.
- Effective management of denied claims: For an AR department working on denied claims is quite an important task. Identification of the causes that led to the claim denial and resubmission of the same without faltering is a very crucial task that needs to be performed flawlessly. Moreover, an AR team needs to focus on finding out the trends that lead to claim denials.
- Follow up by AR: If the claim that has been submitted for a period of 30 days remains unpaid then the AR team is responsible for taking action without causing any kind of delay. It is the responsibility of the AR team to make sure that the claims do not remain underpaid or there aren’t any overdue that need to be looked into.
- Making use of the right kind of software: Even though manual AR is effective it is important to remember that many aspects of the healthcare industry are technologically driven. Therefore, having the best software will only ensure increased productivity.
When it comes to taking good care of medical billing and revenue cycle management, companies like Synergy HCLS can help you out in every possible way.
