A/R Best Practices
Your billing software’s reporting mechanisms can be extremely helpful in finding revenue leaks, as well as identifying appeals areas and possible “red flags” that might require your attention. Best billing practices require a turnaround time of no longer than 30 days in accounts receivable (A/R). With the technology available to the modern facility, there is no excuse to allow accounts to sit any longer, or to chance lost revenue and missed billing opportunities. It is best to assign not only an administrative person to review your reports, but also a billing and coding staff member to provide guidance and details.
Learning how to decipher the numbers helps you to get a full understanding of what really is going on in the facility. For instance, what is your ratio of appeals to submissions? Monitoring the amount of time exerted on appeals is necessary to determine what type of problem may exist. Is there a particular service being denied frequently? Has your rate of collections declined? If so this could be indications of changes in medical policies that have been missed, or an indication that staff training is required.
You should also monitor your individual payer contracts and the payment rates associated with them. Such individualized data are a handy tool to deciphering expected payments in the door, as well as inappropriate payment and billing patterns.
Copies of contracts should be readily available so that the terms are easy to load into your practice management software, thereby ensuring that you are alerted if the proper payment is not received. Setting this up initially takes work—you must enter all the information into the system—but takes only a few hours to update annually.
Do not write off denials without a supervising signature. It’s not uncommon for facilities to lose vital revenue because billers incorrectly wrote off charges that should have been paid.
Success in revenue management is in the details. Following your A/R closely allows not only for complete and timely payments, but also provides a first look at what may be a growing trend or problem area in your practice. Such proactive measures are increasingly necessary in an environment of constantly changing rules and government regulations, and help to keep your facility afloat in tough economic times while minimizing the chances for potentially agonizing payer reviews and audits.