Overcoming common issues in Accounts Receivable Management
In healthcare, like all businesses, the most effective way to collect your unpaid accounts is by reaching out and talking to the customer. The number of patients treated and the number of hospitals and physician services are increasing consistently, keeping the doctors & their staff occupied. As a result, they miss to follow up on a massive chunk of their revenue from the patients & insurance companies.
What is AR calling?
Most Central Billing Offices (CBOs) and outsourced billing companies rely on dedicated accounts receivable calling to overcome their receivables' challenges. The AR calling team works on pending receivables with insurance companies. They ensure that a hospital or practice runs smoothly by recovering overdue payments. The accounts receivable follow-up team is also responsible for looking after denied claims and reopening them to receive maximum reimbursement from the insurance companies.
AR follow-up has evolved from using in-house staff to requiring personnel with specialized skill sets. Running an AR calling team needs a solid understanding of the receivables patterns as well as diligent processes to follow-up and close underlying issues
In this article, we list some of the critical operational issues and solutions to overcome them.
Critical operational issues in Accounts Receivable calling and solutions
Lack of Process Knowledge
A/R calling requires a deep understanding of the multiple issues causing claim denials or delays in payments. These issues require corrective measures to be taken. Such measures involve providing information related to the specific insurance, claims, or treatments causing such delays or denials. Inefficient follow-up leads to multiple calls for the same issue and displays a lack of confidence in claims resolution.
Solution:
Provide ongoing training to your calling team
Assign callers to specific insurance or physicians to avoid confusions in the protocols being followed
Ensure that your callers pay utmost attention to the call to avoid unnecessary repetitions
Embedding denial reason-based call tress can create consistent documentation and eliminate gaps in information capture
Insist that the callers review the claim and route the claim back to web-follow-up teams for cases where the payer does not provide initial claim status through phone calls
Frequently audit the call notes written by your callers
Analyze your A/R data periodically. It can give you a lot of information about your team's efficiency
Gaps in Call Documentation
Call notes should be documented in a structured manner and immediately or during a call. Delays in the documentation of call notes by A/R team members cause ineffective documentation, missed dialed numbers and missed insurance/patient information. These issues lead to ineffective corrective actions that further delay the resolution and payments.
Solution:
Building a call flow software leads callers to capture the right information for specific denial coders (kick-codes) using objective questions. Operations leaders should look at automation opportunities in call documentation standardization through automated documentation capabilities for each of these issues.
Call recording technologies offer an excellent solution for retrieving or crosscheck missing information
Train your calls periodically to consistently follow the team's documentation protocols and processes appropriate to your billing company
Audit the calls and the information collected by your callers regularly\
Importance of call ethics
AR calling ethics includes maintaining a neutral tonality and displaying hospitality while speaking to patients or insurance representatives. There might rise instances of callers being rude or impolite to the patients & insurance representatives when they fail to obey these basic ethics.
Solution:
Callers should be polite and maintain professionalism with the insurance representative & patients at all times
The caller should ensure that their environment is devoid of any unwanted noises when on a call
The callers should use a very warm yet neutral tonality and communicate with great clarity with the patients & insurance companies
Each caller should be audited based on their workflow volume. Remedial training can help minimize errors and improves collections.
Outsourcing your Accounts Receivables
Outsource your Medical Accounts Receivable process to experts like Medical Billing Wholesalers can bring structured A/R management processes and lead to collections improvements. We train and employ callers with healthcare knowledge, RCM expertise, and excellent communication skills. At MBW, we follow a stringent audit process and strive to keep error percentage <1% while improving collections by 25%.
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