How To Revisit Hospital AR for Exciting Reimbursements

February 14,2017 / By Josh Knoll

Josh Knoll

It is true that with every delayed day, medical claims that sit in the system of the payer makes it challenging for a practice, facility or the physicians to get the payments.

The Hospital AR that is still awaiting the payment requires effective account management strategy. Reducing the burden of pending AR is a pain area that hospital facilities need effective intervention.

One of the critical aspects that are to be considered while working with Hospital AR is the reduction of every single day that is directly responsible for a billed to be claimed and get it collected.

Average AR days according to many experts of the industry should be ideally less than 50. Some even consider 30-40 days to be even preferable.

However, it is quite unrealistic especially for emergency departments as well as the hospitals.

But, the fact remains that the key performance indicators financially for a healthcare provider eventually depends on the cumulative days in accounts receivable and the net revenue on the basis of the cash collected.

Controlling the entire revenue cycle with robust processes and functional best practices is the key to minimizing days spent in AR.

Correction of the data that the front office sends

During the referral or registration process of the patients, it is pertinent for the front office to accurately identify the insurance plan and the provider.

  • Eligibility verification process, documenting the reason for the patient visit and all other details with billing address has to be attended with meticulous detailing.
  • One of the key advantages of this will be setting the tone to ensure that the medical claims are not sent back repeatedly to the front office for collections that save both time and billing costs.

 Streamlined Collection of the co-pays

It is important for any hospital or specialty healthcare providers remember that insurance isn't the ones that are only responsible for the payments, patients are as well!

  • It is important to collect nearly all of the co-pay either before the admission or the before patient care services are rendered.
  • Experts indicate that at present, a paltry 3% of hospitals collect a significant amount of co-pays from the patient.
  • It is a significant contributor that can be used to trim the days spent in AR. Elective surgeries especially can be targeted for maximizing on the co-pays from the patients.

Charge Capture that is efficient

To get impeccable documentation of the services at the point of patient care, you will need accuracy in charge master.

  • It is extremely crucial to integrate your EMR with your charge master to help it in updating changes quickly and effectively.
  • To ensure a documentation process that is concise and clear, use scribes for quality documentation of the real time encounter of the patient that will make the process of medical coding easy for the billing office.

Decisive Systems of Information

The EMR system should have the necessary modules or the customized features that will make order entry easy.

  • It should also provide the right support for the decision in medical billing and coding.
  • Capturing the data with the assistance of the right interfaces in coding and billing software helps to analyze the AR days in a better manner.
  • Factors like the medical procedure or the service, payer and the physician side requirements can be drilled that answers the reason for the delays.
  • Arming you with the required information to argue further for better service is also a significant advantage with the use of robust information systems.

Medical Coding that is clean

Medical billing and coding should continue simultaneously. Medical coding that is based on complete documentation that is accurate helps in faster reimbursements. It helps in outlining the entire procedure followed in accordance to the claims adjudication guidelines.

Real-time interactions have to increase so that billing documents supports the coding generating better ROI. Claims submission that is enabled with better denial management shorten hospital AR drop time and assist in maximizing financial returns.

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