Realistic Old-AR Recovery
Posted by Deepak Sanghi on July 4th, 2015
AR and denial management are quite tricky to handle and may get complicated if delayed. Recovering AR is time-consuming and tough, but at the same will be even more challenging if the AR gets older than 180 days. Although healthcare entities follow-up on unpaid claims and appeal for denied claims, there is still a significant amount of AR piled up in their medical billing systems. The reason is that they have to look after handling old AR with a more realistic approach - what could be called as the realistic old-AR recovery. Prudent medical claims processing and medical billing AR follow-up is necessary for this approach. Let us take a look at it:
Recurring Claim Denials: There are certain claims that get denied repeatedly; no matter how many times healthcare entities re-submit them. Such claims may never get paid at all. For instance, if a patient undergoes physical therapy, then the Provider is allowed to provide the service only the number of times specified in the insurance plan that year. In case the service provided exceeds the ‘MAX’ specified in the plan, then the claim may get rejected. There is no use even if it is re-submitted multiple times. Insurance eligibility verification plays a vital role in this scenario. Practices must check a patient’s plan before providing a service.
Claims Paid Already: Unaware of the fact that a particular claim has been paid already, many healthcare entities still make the mistake of resubmitting paid claims. This scenario occurs when the medical claims processing specialists fail to post the payments onto the medical billing system once the claims get paid. End of the day, the outstanding AR looks inflated in the billing software. It is essential that healthcare entities use high-end electronic remittance technology that will help in posting insurance payments automatically onto the billing system. A reputed offshore medical claims processing company can help with the same.
It is Easy if it is In-network: When is the Providers or Health entries are out-of-network, the old AR recovery gets complicated. The reason is that insurance companies do not take much responsibility in paying claims directly to Providers if it is out-of-network, and they pay directly to the patients. Following up with patients can be a herculean task for Providers and they have to rely on collection agencies for payments due. On the other hand, if the service is provided by an in-network provider, then the Payers will take more responsibility. As a result, the old AR recovery will be much easier than imagined. An experienced offshore medical billing company like e-care can ease out these processes.Thus, healthcare entities must follow a realistic approach in recovering old AR.
About e-care India:
E-care India has 15 years of experience in the healthcare RCM industry.E-care’s3 offshore medical claims processing delivery centers have been providing end-to-end medical billing AR follow-upend denial management services seamlessly to its clients. To know more about e-care and its services, log on to www.ecareindia.com.
