Reviewing your practice's Accounts Receivable procedures in a different healthcare environment
There are a number of things your practice should investigate first:
- Look at your accounts to determine how many days are your typical average. Did this number increase over the past year? When pulling these reports, investigate whether the change is due to payers or related to employees working remotely and/or adjusting to new, different office procedures.
- As soon as you identify the cause or causes, create some goals. You want the patient claim information with the most up-to-date codes, correct patient data and health insurance information, as well as any necessary additional documentation to be received by your billing staff within 48 hours of the patient interaction.
- That takes you to the next step – communication. Are you adequately communicating with your providers on changes to codes (example – are they billing for time under the revised E/M codes)? Does your front desk staff understand the need for accurate personal and insurance information in the record and should check every time a patient is seen – virtually and in-person?
- In the billing office, is there a process for looking at and tracking denials? Maybe you identify this as a constant issue with one payer. Make sure you understand the requirements for your top payers – there may be specific documentation required that is not necessarily needed with other payers. How much time does each payer allow for appealing a denial, and are you meeting those deadlines?
- In addition, look at how much time your staff spends on resolving claims. Your practice may be better served to create a list of top payers or those high-value procedure codes to ensure that time spent will provide the most return on investment.
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