AR calling in Revenue Cycle Management Companies

How critical is AR calling in Revenue Cycle Management Companies?

Will you be satisfied with your medical practice if you experience frequent denials and loss of payments for the services rendered? Do you think revenue cycle management companies would be the right choice for AR follow ups?

Well! It’s most obvious that denials can push healthcare professionals deep into revenue loss and it’s always better to approach best AR follow up team to overcome denials and drive straight to revenue profits.

Anyways, what can be motivating is outsourcing the best revenue cycle management companies for AR follow up process to increase revenue payments.

Why is it necessary to have AR follow up?

  • The account receivable follow up team is very essential and responsible for having regular follow up on the denied claims and resubmitting them to receive reimbursements and revenue profit.
  • Earlier medical billing and RCM services were handled by healthcare professionals with in-house billing.
  • At present, it requires experts to handle denial management that demands efficiently skilled medical billing professionals to take care of AR follow ups.
  • It is to be noticed that other vital processes such as charge entry, insurance verification and payment posting are to be completed accurately prior to AR follow up.
  • Revenue cycle management companies pay keen attention during the medical billing procedures that decides accurate medical coding for the diagnosis based on the service rendered by healthcare professionals.
  • If revenue cycle management companies fail to adhere to the rules of insurance companies, there is a chance where the payers deny the submitted claims which causes huge loss.
  • So, it’s crucial to concentrate on AR follow up for a perfect denial management process and prevent revenue loss.

Stages of AR follow up in Revenue Cycle Management Companies

  • Usually, most of the revenue cycle management companies maintain a systematic process especially for AR follow up. It consists of three stages.
  • Initial evaluation
  • Analyze and prioritize
  • Payment Collection
  1. Initial Evaluation:

  • It involves analyzing and identification of submitted claims that’s listed on AR aging reports.
  • This allows the team to review or check the healthcare provider’s policies and recognize claims to be concentrated and cleared.
  1. Analyze and prioritize:

  • This stage includes the unpaid claims that are opposed to pay by the insurance companies and the marked  uncollected claims are analyzed and prioritized for better revenue payments.
  1. Payment Collection:

  • The identified claims are resubmitted to the insurance companies within the timely filing limits with the accurate and required information abiding the policies.
  • After resubmission of claims, the payments are posted and followed up after patient bills are generated according to the providers’ guidelines for revenue payments and growth.

Account Receivable responsibilities:

  • Determining the post work of the medical billing work involved by the revenue cycle management companies, the major tasks of Account Receivable is divided into two areas or departments.
  • AR analytics
  • AR follow up
  • AR analytics holds the responsibility of checking the claim thoroughly and resubmitting those claims with necessary corrections within timely filing limits.
  • It also checks and identifies medical coding errors or verification errors to re-correct and submit those claims for revenue payments.
  • AR follow up takes the control on communicating with the healthcare professionals, payers, patients as well as hospitals if essential to act according to the responses or feedback from their clients.
  • The quality service delivered by the account receivable team actually aids in stimulating revenue growth.

Important reasons for AR follow up requirements:

  • Financial stability of healthcare organizations
  • Helps to recover overdue payments
  • Minimizes time for outstanding accounts
  • No claims will go missing
  • Follow up on denied claims
  • Claim Recovery
  1. Financial stability of Healthcare Organizations:

  • The financial stability of healthcare organizations and healthcare professionals depend on the positive enhancement in revenue generation or cash flow.
  • The healthcare organizations or the hospitals will have to maintain a constant revenue flow and provide better patient responsibility in which AR follow up team assists and ensures revenue profits or growth.
  1. Helps to recover overdue payments:

  • AR follow up team ensures hospitals, healthcare organizations and healthcare professionals to overcome the denials and recover payments within limited time span.
  • It becomes easy for the healthcare professionals to receive payments on time when AR follow up does the duties without hassle and passes post payments for the delivered services.
  1. Minimizes time for outstanding accounts:

  • The main motive of account receivable management is to minimize the time for the outstanding accounts.
  • The expert team does a regular tracking on the unpaid claims, evaluates a suitable action for a secure payment and establishes a secure procedure to continue secure payments.
  1. No Claims will go missing:

  • The predominant reason for claim denials is that the claim is either missed or not processed.
  • When the claims are missed, it’s because of the claim papers being lost or missed in the provider’s office or payer’s office.
  • It’s safe and secure to use electronic forms to send the claims as it becomes much easier to follow up on the claims and will know if the claims are not being submitted or received.
  1. Follow up on denied claims:

  • Every claim denial holds a reason. If not there is a chance for the third party to process the payments when revenue cycle management companies appeal for invalid reasons of not posting payments.
  • After finding the reason for claim denials, it’s possible to resend the claim with accurate information within payer’s time limit.
  • Call the insurance companies for the denial reason and follow up on the denied claim regularly to ensure all the payments are posted after perfect claim follow up.
  1. Claim Recovery:

  • At times claims are kept separately waiting for further information from the patient or member.
  • AR team follows up with the patient to gather the required additional information and takes certain actions those will ensure better revenue reimbursement.

Best Practices for AR Calling

AR calling is quite a cumbersome task in the revenue cycle management department. However, with the right resources and the correct strategy, you can move forward to maximize the revenue for your provider organization.

  • Being prepared with the necessary documents is the first step that you should take before dialing the phone. Keep all the papers related to the particular claim handy with you and study them well so that you can answer any required question during the call.
  • Efficiency in the AR calling process could make or break the deal with the insurance company. So make sure you have the necessary invoices, proof of medical necessity, correct patient details and account status with you so that you can quickly refer to them as and when needed.
  • Experts in AR calling domain suggest recording the previous call logs for future reference. For example, if you are talking to a new executive from the insurance company, you can refer to the issues already resolved and move on to the next part of the process. This helps boost efficiency to the AR management and at the same time builds a rapport with the insurance professional.
  • Prepare your speech beforehand by taking notes from the previous transactions and account details. Refer to the provider contract made with the insurance provider to support your claim. Many times, the revenue realization does not take place due to lack of medical necessity.
  • Get in touch with the provider and ask for documents for the same. There is even precedence of cases where the insurance reimbursed the amount citing scientific data even though the same was not explicitly mentioned in the contract. Request them for similar documents so that you can mention the details during the call and fax the papers if necessary.
  • Lastly, make sure that you are confident and fluent with your conversation. The most challenging part of AR management is following up several times with the insurance company before they actually move through with the request. Make sure you have a proper scheduling process in place to prioritize the calls.
  • Experienced and successful AR callers mention that they prioritize the calling process according to the amount of the claim and the number of AR days. Evaluate the claims frequently to see which of them has the best argument along with sufficient proof for the process to go through.

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