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Thread: a/r

  1. #1

    Default a/r

    AAPC: Back to School
    How do you guys run your a/r reports? I feel I could be doing more, my employer just has me call in insurance to see how much was paid and when, and if not then rebill the claim is this all there is to it?

  2. #2
    Join Date
    Apr 2007


    That's pretty much what we do too.... Working any denials and appealing as need be along the way

  3. #3

    Default 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.

  4. #4

    Thumbs up

    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
    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!
    Cyndee Weston, CPC, CMC, CMRS
    American Medical Billing Association
    AMBACode Coding Software
    2015 AMBA National Medical Billing Conference

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