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.
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!
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.
Decisive Systems of Information
The EMR system should have the necessary modules or the customized features that will make order entry easy.
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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