AR- Accounts Receivable

Accounts Receivables or AR is also known as Patient Accounts is basically money that is owed to the provider based on the different patient accounts, for services rendered and the same is payable by insurance firms and/or patients. It is an indication of the revenues earned or generated but not realized. The aggregate of the money that is owed to all providers, the practice can expect the money to be paid in the course of the month or over a period of time.

Accounts Receivables requires terrific management, a good monitoring and following up methodology. It is only with this process can the actual revenue earned be realized and thus bring down the percentage of accounts receivables owed to the practice. Therefore, this is one of the core objectives of any practice, healthcare facility or billing company.

Accounts receivables include managing reports that deals with insurance, collection investigation, write-offs, bad debt reviews and ratio breakdown. It also includes insurance contracts analysis as this ensures that healthcare providers are reimbursed promptly and properly.

Importance of A/R or Account Receivables in the medical billing cycle

On a daily basis, providers or physicians provide consultation, treatment and different types of services to their patients. For this, the patients have to pay or owe a certain amount of money to their providers. This is either directly paid by them or paid on behalf of them by their insurance provider. Therefore, this aspect of medical billing is gaining a lot of importance as it is a crucial part and one that keeps a practice going and also ensures definite translation of all the money owed to them. Before this process, there are many processes that precede and which also have to be followed and done correctly. Processes like charge entry, patient registration, insurance eligibility verification, payment posting etc. has to follow the set procedural norms so that the A/R is attainable.

Typically, after approval the claim is sent to the insurance company for processing. But the claims that are sanctioned also include denials and hence an experienced team in place, performs regular checks and follow-ups to reduce the denial rates. So there is a great deal of work or processes to be carried out before a physician actually realizes their money.

The A/R team has to analyze and scrutinize the denied claims, rejected or partial payments and also non-payments. If in case, there is a wrong submission, the same is rectified and sent out again. It is the A/R team that is in touch with the billing office, or client, insurance company, practice and the patient. Good analytical skills and knowhow, an eye for detail all make up the qualities of a good A/R analyst. As it is the A/R analyst’s effective handling of cases that determine the financial wellbeing of the medical practitioner, hospitals and medical offices.

Areas of Accounts Receivables Management

Accounts Receivables (AR) management engenders all areas of a medical practice. Accounts receivable management techniques that have proven to be successful need a complete understanding and knowledge of the different areas that contribute towards its success in realizing revenue that is owed or outstanding.

  1. Legal understanding of regulations and rules

  2. Contract negotiations with the insurance agencies and managed care organizations

  3. Compliance policies

  4. Patient rights and needs

  5. Patient right of entry and access

  6. Capturing charge entries

  7. Health information management

  8. Financial services for patients

Why HealtyPay Inc. for Accounts

Receivables Management

The most important feature in the medical billing cycle is Accounts Receivables Management. Therefore, it is but reasonable to have experienced personnel and a proper system to manage the accounts. A well-devised system that has a good internal and external reach and control over all the accounts would help recommend solutions to recover the money that is owed to providers in a quick pace. It is the A/R team that works closely with the providers, insurance companies and patients to realize the amount.

The benefits of engaging the A/R services rendered at HealthPay Inc. include:

  • Payor/insurance recording or following-up

  • Patient payment follow-up

  • Analyzing the receivables

  • Managing the denials and appealing for the same

  • Refunds management

  • Filing secondary claims

  • Techniques of how to deal third-party payors

  • Track outstanding receivables balances

  • Settlement guidelines and measures

  • Billing methods

  • Appropriate insurance eligibility verification

  • Directives on collection practices

  • Engaging in appeals for any challenged claims

  • Document indexing against respective patient accounts

  • Credit balance audit activity

  • Cleaning-up of special projects

  • Tailor-made management and performance management reports

  • Generate periodic reports on the status and positions of the accounts

  • Improved revenue inflow with lesser days in A/R, better profit margins and collections ratio

 

Work Flow

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