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Wiki a/r
- Thread starter cingram
- Start date
jkh429
Networker
That's pretty much what we do too.... Working any denials and appealing as need be along the way 
re: a/r reports
We break down the payers into categories i.e. Medicare, Commercial, BCBS etc. Then we run monthly reports by category breaking it down further into "buckets" 0-30 days old, 30-60 etc.. We work the oldest accounts with the highest dollar balance first. From there we go by payer.. i.e. if there is a payer with a short filing limit (90 days) they get worked first. We don't bother with the 0-30 bucket because that is a waste of time. The trick is to not spend too much time on super old accounts that you neglect the semi-old
(45-90 days). I generally have staff broken down by payer categories and they spend 2 days on old accounts, 2 days on semi-old, and 1 day following up on denials received that week from payment posters.
Hope that helps.
We break down the payers into categories i.e. Medicare, Commercial, BCBS etc. Then we run monthly reports by category breaking it down further into "buckets" 0-30 days old, 30-60 etc.. We work the oldest accounts with the highest dollar balance first. From there we go by payer.. i.e. if there is a payer with a short filing limit (90 days) they get worked first. We don't bother with the 0-30 bucket because that is a waste of time. The trick is to not spend too much time on super old accounts that you neglect the semi-old
(45-90 days). I generally have staff broken down by payer categories and they spend 2 days on old accounts, 2 days on semi-old, and 1 day following up on denials received that week from payment posters.
Hope that helps.
cyndeew
Guru
- Messages
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- Best answers
- 0
To get an even clearer picture of what's happening with A/R, we suggest that offices set up specific codes to track for insurance, writeoffs, deductibles, copays, etc. For example:
BCBS = Blue Cross Blue Shield Payment
AETN = Aetna Payment
MDCR = Medicare Payment
UHC = United Health Care Payment
BCBSW = BCBS Writeoff
DED = Applied to Deductible
HRDSP = Hardship Writeoff
PROF = Professional Courtesy Discount
CASHD = Cash Discount
UNIND = Uninsured Discount
NSF = Non-Sufficient Funds Check
This allows you to run a much cleaner practice analysis report for a given period of time (monthly, yearly, etc.) and will allow you to analyze what's going on with the money.
Additionally, you should set up denial codes that allow you to track denials so that you can identify problems quickly --
TIMELY = Not Timely Filed
PREX = Pre-existing Conditions
NMN = Not Medically Necessary
NC = Not Covered
DNC = Diagnosis Not Covered
GP = Global (inclusive) Procedure
NPA = No Prior Authorization
You can't analyze & manage what you don't measure...
To do a quick analysis, ask these questions:
Do payers consistently account for about the same percentage of aged A/R?
Are the contractual adjustments ratio stable?
Is the Net Cash Flow at least 90%?
Is less than 20 percent of total A/R aged 120 days or more?
Is aged A/R distributed evenly among the physicians in your group?
Is the total outstanding A/R greater than 3 months gross charges?
Rule of thumb regarding A/R Buckets:
50% of A/R should be 30 days or less
BCBS = Blue Cross Blue Shield Payment
AETN = Aetna Payment
MDCR = Medicare Payment
UHC = United Health Care Payment
BCBSW = BCBS Writeoff
DED = Applied to Deductible
HRDSP = Hardship Writeoff
PROF = Professional Courtesy Discount
CASHD = Cash Discount
UNIND = Uninsured Discount
NSF = Non-Sufficient Funds Check
This allows you to run a much cleaner practice analysis report for a given period of time (monthly, yearly, etc.) and will allow you to analyze what's going on with the money.
Additionally, you should set up denial codes that allow you to track denials so that you can identify problems quickly --
TIMELY = Not Timely Filed
PREX = Pre-existing Conditions
NMN = Not Medically Necessary
NC = Not Covered
DNC = Diagnosis Not Covered
GP = Global (inclusive) Procedure
NPA = No Prior Authorization
You can't analyze & manage what you don't measure...
To do a quick analysis, ask these questions:
Do payers consistently account for about the same percentage of aged A/R?
Are the contractual adjustments ratio stable?
Is the Net Cash Flow at least 90%?
Is less than 20 percent of total A/R aged 120 days or more?
Is aged A/R distributed evenly among the physicians in your group?
Is the total outstanding A/R greater than 3 months gross charges?
Rule of thumb regarding A/R Buckets:
50% of A/R should be 30 days or less
25% of A/R should be 31-60 days
15% of A/R should be 61-90 days
10% of A/R should be 91-120 days
Nothing should be in the Over 120 days bucket (Ideal, but usually not reality)
Hope this info helps you!
15% of A/R should be 61-90 days
10% of A/R should be 91-120 days
Nothing should be in the Over 120 days bucket (Ideal, but usually not reality)
Hope this info helps you!