Maintaining accounts receivable is necessary to improve your billing process. Daria Semanyshyn of Advanced Medical Practice Management discusses four steps to audit your A/R and catch problems in a timely fashion.
1. Run monthly A/R reports. Ms. Semanyshyn says your billing management should run monthly reports and maintain a spreadsheet that recaps monthly charges and payments, month-end aging buckets, average days in A/R and A/R over 90 days. "Within a few months, you should be able to determine your center's norm and positive and negative trends," she says.
She says monthly reports are essential to a healthy A/R, as any increase in aging buckets, average days in A/R or A/R over 90 days should be addressed immediately. "Don't wait another month to see if things stabilize," she says. "More often than not, changes to these numbers indicate problems."
2. Enforce follow-up procedures. Once your billing or A/R manager has identified problems in your A/R trends, he or she should follow an established policy to make a record of the error. Ms. Semanyshyn says these policies should include "making notes in your billing system describing the action to correct the claim." The notes should include reference numbers, names and date from your contact with the insurance company.
3. Review unpaid claims. Every month, your billing supervisor should review every unpaid claim to make sure staff members are following up on correcting and appealing claims. "This should be done as a normal monthly routine to ensure accountability of the work your staff is performing," she says. If you audit staff follow-up practices on a monthly basis, you will be able to catch poor performance or claims that have fallen through the cracks in a timely fashion.
For ASCs without the resources to conduct routine audits, Ms. Semanyshyn recommends conducting a staff audit at the first sign of spiking aging buckets or an increase in average days in A/R or A/R over 90 days. "This is why keeping a spreadsheet with monthly numbers is so important," she says.
4. Maintain a list of "top 20 reasons a claim denies." Ms. Semanyshyn says her staff keeps an A/R error log that lists the top 20 reasons a claim denies. "From every step of the revenue cycle, reasons for rejects and denials are checked off on this log," she says. The "top 20 list" is an important managerial tool because the A/R supervisor can determine where the cause of denials and rejects lies. If a specific staff member is frequently responsible for claims and denials, she says they should be held accountable for those mistakes and let go if performance does not improve.
Learn more about Advanced Medical Practice Management.
Read more about A/R:
-10 ASC Benchmarking Statistics on Average A/R Days Outstanding
-Practical Guidance: The Most Common Reason Claims Are Denied
1. Run monthly A/R reports. Ms. Semanyshyn says your billing management should run monthly reports and maintain a spreadsheet that recaps monthly charges and payments, month-end aging buckets, average days in A/R and A/R over 90 days. "Within a few months, you should be able to determine your center's norm and positive and negative trends," she says.
She says monthly reports are essential to a healthy A/R, as any increase in aging buckets, average days in A/R or A/R over 90 days should be addressed immediately. "Don't wait another month to see if things stabilize," she says. "More often than not, changes to these numbers indicate problems."
2. Enforce follow-up procedures. Once your billing or A/R manager has identified problems in your A/R trends, he or she should follow an established policy to make a record of the error. Ms. Semanyshyn says these policies should include "making notes in your billing system describing the action to correct the claim." The notes should include reference numbers, names and date from your contact with the insurance company.
3. Review unpaid claims. Every month, your billing supervisor should review every unpaid claim to make sure staff members are following up on correcting and appealing claims. "This should be done as a normal monthly routine to ensure accountability of the work your staff is performing," she says. If you audit staff follow-up practices on a monthly basis, you will be able to catch poor performance or claims that have fallen through the cracks in a timely fashion.
For ASCs without the resources to conduct routine audits, Ms. Semanyshyn recommends conducting a staff audit at the first sign of spiking aging buckets or an increase in average days in A/R or A/R over 90 days. "This is why keeping a spreadsheet with monthly numbers is so important," she says.
4. Maintain a list of "top 20 reasons a claim denies." Ms. Semanyshyn says her staff keeps an A/R error log that lists the top 20 reasons a claim denies. "From every step of the revenue cycle, reasons for rejects and denials are checked off on this log," she says. The "top 20 list" is an important managerial tool because the A/R supervisor can determine where the cause of denials and rejects lies. If a specific staff member is frequently responsible for claims and denials, she says they should be held accountable for those mistakes and let go if performance does not improve.
Learn more about Advanced Medical Practice Management.
Read more about A/R:
-10 ASC Benchmarking Statistics on Average A/R Days Outstanding
-Practical Guidance: The Most Common Reason Claims Are Denied