The accounts receivables have to be collected in the shortest time possible for proper management of the revenue cycle. Another name for accounts receivable is patient accounts, that denotes the revenue generated but not yet realized. To generate enough cash flow for effective management, the medical office needs to maximize the revenue potential.
According to estimates from authentic sources in the medical industry, the average ranges from 10% to 25% for the denial of all claims. However, according to the MGMA, the top performing groups offering medical services say that denial rate should not exceed 4%.
The delays in collection, outstanding claims and denials put additional strain on medical staff, doctors, clinical and hospital procedures as well as many other key resources. It is a preventable disruption.
On one hand, the insurance firms normally deny claims or even refuse to pay them all together because of very minute document discrepancies let alone several other reasons. On the other hand, the Federal convention has become too hard-hitting in the United States of America.
The collection of A/R requires experience and professional attention that comes from experience and expertise.
1. Review of All the Previous Claims:
It is a crucial step that significantly chops down the error rate. Removal of discrepancies in documentation is also done. Medcare MSO spends time on the appraisal beforehand instead of dealing with each and every denial for a long time reflecting the professional approach.
2. Billing and Coding Logs are Kept:
The medical billing company keeps the record and tracks of every Healthcare Business Process Outsourcing (BPO) Provider. It is based on the payment advice from Medicare in addition to Explanation of Benefits (EOB) from each third party payer.
The billing company studies these trends and explore the means to mitigate the problems and fixes the money leakages and loopholes resulting in a better denial and rejection management of claims. It all boils down to the benefit of a provider.
3. Billing review every month:
Meetings of all the employees involved with account receivables (AR), denial analysis, bill postings, documentation, CPT coding, all the way down to data entry operators are called every month to evaluate the service. This maintains high levels of performance and operational quality.
As the medical practices including clinical operations and house call growing by the year, Medcare MSO understands its clients.
Every time a patient receives medical care, he or she owes a certain amount to his or her healthcare provider in one form or another. Its redemption means that the medical work facility should be well compensated ensuring smooth and efficient operations. It enables medical institutions to continue to combat disease and ailments while maintaining high standards of operational functionality.
4. Dedicated A/R Teams for Accounts Receivable Recovery:
Medcare MSO has dedicated teams for tracking and reopening denied claims so the maximum monetary recovery takes place from insurance provider firms. Revenue Cycle Management and Medical Billing Accounts Receivable Management handled by in-house teams at medical facilities are history now, these sensitive monetary and finance operations require dedicated professionals with significant skill sets who know exactly what they are doing when it comes to AR follow-ups.
There are a number of other important billing and CPT coding procedures, other than AR recovery management. It includes payment posting, charge entries, and verification’s that a billing company performs on the behalf of medical practices. Medcare MSO also deals with precise medical, diagnostic and surgical codes with their intricate details based on the medical treatment plans.
All claims that are categorized into to filling at insurance companies, get refiled after the authentication of all the billing information such as compliance to medical billing regulation and standards along with claims processing.
When unresolved claims are finalized with the posting of their payment details, the patient bills gets generated and the billing professionals follow it up with the concerned patients for the reimbursement of funds.
Medcare MSO is at your deposit 24/7. We help you dramatically improve your revenue cycle and get the funds that are stuck in the insurance recovery pipeline for a very small fee.
Our services are highly useful for many of the medical practices that medical institutions provide. Medcare MSO helps you as a medical provider to grow, evolve and succeed in your endeavors, something that you do best after freeing yourself from all your CPT coding and Billing worries.