A/R Follow-up in Medical Billing

Medical billing is a complicated process that requires special skills in medical billing, coding, denial, and AR management from experienced and well-trained staff. The financial health and success of any medical practice are dependent on maintaining positive cash flow. In order to provide patient care and cover expenses, it’s important that payments are not delayed, lost, or denied. With the understanding of billing guidelines and a highly trained staff in place, you’ll start to reap the benefits of high first-pass acceptance rates and shorter billing cycles. But even when everything goes right, some claims will still be rejected or denied. The accounts receivable (A/R) follow-up team in a healthcare organization is responsible for looking after such denied claims and reopening them to receive rightful reimbursement from the insurance carriers. Even though these claims could be held up by simple mistakes, you will be surprised to know that over half of denied or rejected claims are never reworked. This means that the average healthcare provider is leaving thousands of unclaimed dollars on the table every year. In this article, we just highlighted some key benefits and overall importance of A/R follow-up in medical billing. 

Importance of A/R Follow up

Claim follow-up: It may possible that all submitted claims are not received by the insurance carrier or your billing team might have missed submitting some claims. One of the biggest delays in payment is resulting from the claim not getting filed. In simpler words, the claim wasn’t received by the insurance carrier. This normally happens after paper claims get lost or misplaced somewhere along the way before they are delivered. To avoid such blunders, it’s wise to send claims electronically if you can. In case the claim has not been followed up on quickly, it could be weeks or longer before your firm realizes that the insurance firm never received your claim. For paper claims, let 10 business days pass prior to calling the insurance firm to confirm whether the claim was received.

Managing denied claims: Depending on the denial reason, you can actually send out a new claim request with all required corrections before you even receive the paper denial via mail. By contacting the insurance firm and inquiring why they denied your claim rather than waiting for your paper denial explaining the reason through the mail, the A/R team can make sure that all claims get corrected as fast as possible. Resubmitting the claims up to 7 days earlier instead of waiting for the mail will undoubtedly reduce the turnaround time for your payments.

Recover overdue payments: A/R follow-ups assist all nursing homes, physicians, hospitals, etc. in recovering the late payments without a hassle. When the healthcare provider has a team that can constantly involve itself in the claims follow-up procedures, it becomes stress-free for the healthcare provider to receive payments in a timely manner. Your experienced, skilled team will read the explanation of benefits and will resubmit the claim with the required information to receive overdue payments. 

Provide financial stability: As discussed earlier, healthy cash flow provides financial stability to the practice and ensures the smooth functioning of day-to-day activities. Healthcare providers need to maintain a secure flow of revenue to cover expenses and provide the needed patient care services effectively; the A/R department makes sure that all this is taken care of.

Manage pending claims: At times, claims will be kept pending for a certain duration of time as a result of additional information needed for the respective member. By executing a proper follow-up, the A/R team can notify the member regarding the situation so appropriate action can be taken and the entire process is sped up again.

Need Assistance in A/R Follow-up?

Even though A/R follow-up is an important part of medical billing, most practices won’t be able to pay much attention to it due to a lack of skilled manpower. A/R follow-up requires skilled and experienced manpower who have handled specialty-wise billing and handled that specific insurance carrier. Otherwise, such inexperienced and unskilled A/R experts might be unable to handle claim denials resulting in increased rejected payments. In such cases, if hiring a skilled A/R expert is not possible then you can always outsource you’re A/R function to the medical billing company. 

Medical Billers and Coders (MBC) is a leading medical billing company providing complete revenue cycle services. At MBC, one of your daily tasks is pursuing every dollar owed by your practice. Our daily workflow automates this task with a claim follow-up that generates patient and payer collection worklists so you can prioritize follow-up tasks, boost collections, and reduce the days spent in Accounts Receivable in A/R. Simplifying your medical billing process and having an A/R follow-up automated process for reworking denied claims is essential to the success of any practice. To know more about our A/R follow-up services, contact us at [email protected]/ 888-357-3226