A critical component of medical billing that significantly influences cash flow is the management of accounts receivable. Consequently, it is essential to establish a robust system of internal controls to effectively oversee the follow-up of medical billing accounts receivable.

At HANA HealthCare Solutions, our Accounts Receivable Management Services team is designed to serve as a comprehensive solution provider, addressing challenges related to cash flow and functioning as an integral part of the medical billing team. Our primary objective is to expedite the recovery of funds owed to our clients. We focus on enhancing cash flow and minimizing Accounts Receivable days by submitting accurate, error-free claims, conducting thorough analyses of denied claims, and maintaining consistent follow-ups with both insurance companies and patients regarding outstanding claims and balances.

Our Accounts Receivable Management services encompass:

Insurance Follow-Up: Healthcare providers and medical billing companies often incur significant financial losses due to insufficient follow-up on outstanding claims with insurance companies. HANA HealthCare’s AR follow-up services are specifically designed to facilitate timely claim payments

Our dedicated AR follow-up team at HANA HealthCare proactively engages with insurance companies regarding all accounts. Our trained personnel maintain regular communication with insurance providers through various channels, including websites, fax, IVR, and phone, to ensure prompt settlement of claims. The AR Management Services team diligently monitors the aging categories of accounts receivable, ensuring that all claims are followed up within 25 to 45 days from the date of entry, depending on the payer. The medical billing AR follow-up process with insurance companies aims to ascertain the status of claims, appeals, and denial reasons for any rejected claims. Every effort is made to facilitate the reprocessing of claims during direct communication with the insurance representative.

Strategy to Reduce Accounts Receivable (A/R) Aged 90+ Days by 15%

Reducing the percentage of accounts receivable (A/R) aged over 90 days is crucial for maintaining a healthy cash flow and ensuring the financial stability of healthcare organizations. Here are key strategies to achieve a 10% reduction in A/R aged over 90 days:

• Focus on Front-End Processes
  
  • Pre-Authorization and Eligibility Verification: Conduct thorough pre-authorization and eligibility checks before services are rendered. This proactive approach helps confirm coverage and reduces the chances of post-service denials, which can lead to aged A/R.
  • Accurate and Timely Billing: Ensure that claims are submitted accurately and promptly. Proper documentation and coding are essential to avoid initial claim rejections and delays in payment.
• Effective Denial Management
  
  • Analyze and Address Denials: Regularly analyze denied claims to identify root causes and implement corrective actions. Understanding why claims are denied can help prevent future denials and reduce the aging of receivables.
  • Centralized Denial Management: Receiving denials in one location rather than multiple points of entry helps with consistent data collection and root cause analysis, leading to more effective denial management.
• Regular A/R Aging Analysis
  
  • Monthly Review of Aging Reports: Administrators should review aging reports at least once a month to identify trends, determine process improvement priorities, and monitor performance. Billers should review these reports daily to stay on top of outstanding claims.
  • Track Key Performance Indicators (KPIs): Focus on KPIs such as net collections, days sales outstanding, and A/R over 90 days to gauge the effectiveness of your revenue cycle management.
• Utilize Technology and Automation
  
  • Revenue Cycle Software: Implement revenue cycle management software to streamline the billing and collections process. These tools can provide real-time visibility into the billing process, identify the root causes of delayed payments, and automate follow-ups .
  • Collections Technology: Use technology to monitor and track financial performance, identify overdue accounts, and predict claim results. This can help in reducing the turnaround time for payments and improving cash flow.
• Timely Follow-Up and Zero Posting Practices
  
  • Dedicated Follow-Up Team: Establish a team dedicated to following up on aged receivables. Ensure that follow-ups are timely and systematic to maximize the chances of collecting overdue payments.
  • Zero Posting Practices: Ensure that all insurance correspondence is posted and tracked in a timely manner. This practice helps in maintaining accurate records and prevents delays in resolving unpaid claims .