With the increasing number of healthcare services by physicians and hospitals, the loss in payments or frequent claim denials is increasing substantially. This is where A/R follow-ups come into the picture to streamline the operations and ensure a smooth and successful transition between the prospects – patients, providers and insurance carriers.
What is A/R follow-up in Healthcare RCM?
Accounts Receivable (AR) is a process of recovering the bill amounts acquired by the patients to the healthcare providers or physicians from the insurance companies.
A specific team of professionals focuses on recovering overdue payments in the pipeline and ensuring that they are received through a systematic approach with regular follow-ups through calls, texts, or emails.
Different Stages of A/R follow-ups:
A/R follow-ups, in general, consist of 3 different stages:
- Initial evaluation
- Analyze and prioritize
- Payment collection
- This step involves identifying submitted claims concerning AR aging reports.
- With the step mentioned above, it becomes easier for the team to review or check the claims and whether they fall under the healthcare provider’s policies or regulations.
Analyze and prioritize:
- This step involves prioritizing claims that are unclaimed and unsettled by the insurance companies, which helps in better revenue returns.
- The recognized claims are sent again to the insurance companies, where appropriate denial information must be filled in within specific time limits and in line with the policies.
- After claim resubmission, concerning payments are posted and followed up for medical billing with provider’s regulations, resulting in better revenue payments and growth of an organization.
Importance of A/R follow-ups in Medical Billing Processes:
Here are a few reasons that show the desperate need for A/R follow-ups in medical billing:
Providers’ financial stability:
A positive cash flow shows the financial stability of a healthcare service provider. The A/R follow-up team helps maintain a steady flow of revenue, resulting in better patient support.
Recovering payment overdue:
Overdue payments could be problematic. But, with a dedicated A/R follow-up set up in place, rest assured as they help recover outstanding on time.
Reduced time for outstanding accounts:
The primary motive of A/R processes is to minimize the amount of time taken for outstanding bills. The A/R team devises a suitable plan of action for the unsettled accounts and with proper tracking techniques, the claims are processed with timely payments in a stipulated time.
Never miss any claims:
One of the prominent reasons for claim denials is that they go missing or are not processed. To avoid this misinterpretation, paper formats have been replaced with electronic forms. This is the easiest way to monitor whether the claims go missing or not being submitted and could be resubmitted for processing.
To keep the information confidential, sometimes, the claims need further approval from the patients’ families and are kept on hold. Then, with A/R follow-ups, the required data is gathered and claims would be submitted for reimbursements.
Summing it up:
A/R follow-ups have a significant role in healthcare RCM by streamlining the medical billing operations with several techniques for several stages. Companies have in-house medical billing teams to make an organized solution, but outsourcing A/R follow-up processes could positively impact your organization.
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