18 Aug What Do Your A/R Reports Reveal?

We have reached the time of year when the fiscal year is coming to a close for many of our practices, whether that is this quarter or next.  If you haven’t been closely tracking your accounts receivable throughout the year, this is a good time of year to take stock of where the outstanding monies lie for your practice.

The following provides guidance for examining your practice’s A/R.  We’ve included an explanation of what a healthy A/R report looks like within a healthy revenue cycle, and also indicate some areas where a good looking A/R report may not give you the full picture.  We tell you where you need to dig deeper to confidently grasp your practice’s A/R.SperoMD_Reporting

Why do you have high volumes in your A/R Reports?

High A/R could indicate a number of issues with your billing processes.  A healthy A/R aging report is often identified with a high volume of charges aged 30 days or less, with the volume dwindling dramatically across the more aged categories.  However, even an A/R report that looks like this is not automatically indicative of good revenue cycle processes.  Learn these possible pitfalls and you will learn to love your A/R reports as one of the better tools available for assessing your revenue cycle:

  • You have a high volume of patient due balances
    • With the increase in high deductible plans, a greater portion of your overall A/R is coming directly from patients.  If you are not diligent about collecting balances due from your patients, you will see an increase in your A/R.
  • Billers are not working denied  claims as routinely as possible
    • It’s important to keep up with any denied claims received – the quicker you resolve, the quicker you close that open A/R.
  • Billers are not following up timely with insurance companies on unpaid claims
    • As above, it is critical to followup timely with insurance companies on unpaid claims to resolve any open issues causing the insurer not to pay, obtain payment, and close open A/R.
  • Billers are not following up at all with insurance companies on unpaid and denied claims!
    • To appropriately close open A/R, you have to work unresolved claims.  In a busy office, this can be difficult (we understand!), but the key is to devote a little time each day to follow-up to keep up on this important revenue cycle piece.
  • One or more physicians are not properly credentialed with one or more insurance companies
    • Keep a schedule for yourself of when physicians are due for re-credentialing, and be sure to remember to credential and add to your insurance contracts any new physicians who join your practice.
  • You do not have certified coders working your charge review allowing for a greater volume of errors and fewer clean claims submitted to insurance companies
    • Thorough review of charges by certified coders is an excellent way of ensuring full charge capture and sending a higher percentage of clean claim, leading to quicker payment, less work on the back-end, and lower A/R.
  • Your registrars are making mistakes during the registration process
    • Weak front-end processes lead to information errors submitted on claims.  If you strengthen your front-end processes, you will reduce errors and reduce denials associated with registration errors.
  • Some insurance companies are simply relatively slow at paying claims
    • You have one in mind now, don’t you?! Sometimes this is avoidable if you speak with the insurance company.  Often it is unavoidable.  In this case, isolate the affected A/R so that you do not miss another problem, and so that you can look at your A/R but for this one unavoidable problem.

*Note: In addition to these problems related to high A/R, reports that look too good could be indicative of too many write-offs.  A/R reports – specifically A/R aging reports – are one of the best tools for assessing your billing health and isolating the problem areas in your revenue cycle where you should focus your resources.

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