Medical Office Workflow Step 6: Accounts Receivables

If you followed the advice given in the previous articles, you have properly identified the patient benefits, obtained the necessary authorizations, and carefully produced clean claims.  If you missed the blogs discussing these important steps, follow these links:  Step 2, Step 3, Step 4.

clean claimsEach one of these steps is an integral part to keeping a “young” Accounts Receivables (ARs) balance.  They ensure the quickest turn-around time for your claim payments which keeps your cash flow smooth and predictable.

You may wonder why I use the reference “young” when speaking of ARs.  One of the most common ways to evaluate your practice cash flow situation is by analyzing the open balances by their aging.  The aging is most often broken down into “buckets” of 30 day increments: 0-30 days, 31-60 days, 61-90 days, 91-120 days, 121-150 days and 151 days and over.  As the aging increases, the balances should decrease with the highest amounts, hopefully, always in the 0-60 days’ categories. 

medical billing hintAn optimum strategy for keeping your ARs the most current involves two main tasks: 

rejected or denied claimsReviewing all rejected/denied claims as soon as received.  In the case of electronic transactions, claims that contain bad data are pre-screened at the claims clearinghouse and are often seen back in your practice management software within 24 hours for quick correction and resubmittal.  Electronic claims that pass on to the payer can be processed within just a few days by receiving an ERA right into your medical billing system.  

  Iridium Suite Practice Management SoftwareIridium Suite Practice Management software optimizes the advantages of electronic claims responses and remittances with unique warning system.  The user will see visual alerts when claims have been rejected or an ERA contains a denial.  These tools assist office staff to be continually aware of situations that negatively affect your Accounts Receivables. 

rejected or denied claimsRegular monitoring of all claims dated over 61 days for activity by office staff or payer.  Whether you have just had no payer response or you are waiting on a reply to some type of re-submittal, you must evaluate your aging Accounts Receivables for proper activity.  For instance, a claim sent with records for appeal should prompt a call to the payer at least every 4 to 6 weeks for a status update. 

Iridium Suite Practice Management SoftwareIridium Suite Practice Management software is designed for paperless AR follow up with an entire module in the software dedicated to sorting and prioritizing your ARs the way you like to see them.  Specific payers or issues can be divided up and assigned to individual office staff allowing for tracking of progress and positive resolutions. 

The best plan for an efficient and productive medical office is to have a workflow process in place.  Hopefully you can implement the recommendations from this 6 part series to help you and your staff to create an office environment where each person can fulfill their duties with ease and confidence.