** Does your AR report show numerous accounts over 60 days remaining unpaid?
** Is your staff overwhelmed and not able to keep up with reviewing outstanding claims?
** Do you need assistance with reviewing and appealing carrier denials and rejections?
With the holidays around the corner everyone is starting to relax and get excited to plan parties or take some time off. Keeping up the pace to keep working seems to become a challenge, especially when it comes to the dreaded task of following up on unpaid insurance claims.
If you aren’t outsourcing your billing, your billing and coding staff must be given time away from the phones and front desk so they have uninterrupted time to work that AR report. Each unpaid claim over thirty days old should be reviewed with the status noted or steps to correct and resubmit handled immediately.
Checking status online can be a time saver and should be taken advantage of although making actual calls is inevitable. Realize that this can take anywhere from 3 minutes to an hour or more – for EACH one.
How can you determine the time needed to catch up that backlog?
- Run your AR report and get a count of each claim over 30 days old
- Multiply that number by 5 minutes for each one
This gives you an idea of the number of hours needed to check status although you also need to allow additional time to make corrections, pull documents, query the provider for questions – it isn’t always a quick fix.
You will also need to keep in mind that each day will allow some of the claims to fall off the report when a payment is received however, chances are high that more unpaid claims will be added to the report.
We are seeing insurance carriers use any reason to delay or reject a claim and when you aren’t allowing the necessary time and resources to follow up and track unpaid claims you risk rejections for timely filing.
Are there other options – I can’t shut down my office!
Outsourcing your billing, even for a short-term project like cleaning up a backlog of claims is quickly becoming a recognized solution. What are some of the pros and cons?
100% Focus on Coding & Billing – Being outside of the office avoids any chance to be pulled away from the actual intended job
Reduced Overhead – No taxes, deductions, bonuses, PTO, retirement, healthcare etc.
No Sick Days – Unexpected time off delays the billing process, especially when other urgent matters need to be caught up when staff returns
Training & Education – Not only the cost for the actual sessions and materials but additional staff time away from the office
Tax Benefits – Billing Service fees are a deductible business expense
The feeling of losing control – Avoid this by planning and keeping scheduled meetings through Skype, Webex or other online tools
Staff resistance to change – A billing service should express their goal to become part of the team – not “take over”
Transferring Documents – Scanning to a shared, encrypted file allows you to keep original paperwork and avoids postal costs
Contract Issues – Both sides should be clear about expectations and responsibilities
Practice Management System Change – Your billing service should be able to virtually work on your existing system which allows a seamless transition
If you change nothing, nothing will ever change!
My experience with multiple practice management systems allows me to remotely access your existing system so there are no issues with buying new software or transfer of data. I can easily review your reports to identify trends and areas needing improvement which results in optimizing the reimbursement your practice is entitled to.
HD Medical Solutions has worked with solo and group practices for 20+ years on short or long term projects. As an AHIMA Approved ICD-10-CM Trainer as well as a certified coder (CCS-P) my staff and I are ready to assist you with all practice management tasks including credentialing, AR review, ICD-10 / CPT / HCPCs coding, insurance and patient billing as well as EMR implementation or oversight.
Contact me today and we can develop a solid plan which meets your expectations and goals. I look forward to working with you and your practice!