What Do Your A/R Reports Reveal?

20 May What Do Your A/R Reports Reveal?

A/R reports reveal more than just a practice’s outstanding charge detail.  You can utilize A/R reports to identify possible problems in your revenue cycle.A/R Reports

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.

 

Kathleen Heaton has worked in healthcare business operations for over thirteen years, rising through the ranks to perform specialized roles in several capacities.  Kathleen came to PediaTrust, LLC and speroMD from Ann & Robert H. Lurie Children’s Hospital of Chicago, where she was Operations Manager for the independent Children’s Community Physicians Association.  Kathleen is an industry expert in credentialing and managed care contracting, and her primary focus is to oversee revenue cycle management for speroMD’s partners and affiliates.  She is the co-chair of the Practice Management Workgroup with Lurie Children’s Epic Community Connect Program.  Kathleen in currently enrolled at Loyola University in Chicago for her Master of Jurisprudence in Health Law.
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