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Insurance AR

  1. Default Insurance AR
    Medical Coding Books
    Does anyone have any reference materials relating to Insurance AR? How to determine what is acceptable by specialty - OBGYN. I am looking for a way to set goals for our billing employees regarding insurance ar.
    Thank you! Lana

  2. #2
    Location
    Tacoma, WA
    Posts
    1,087
    Default
    Quote Originally Posted by LanaW View Post
    Does anyone have any reference materials relating to Insurance AR? How to determine what is acceptable by specialty - OBGYN. I am looking for a way to set goals for our billing employees regarding insurance ar.
    Thank you! Lana
    So you want to evaluate based on amounts being billed to insurance? Not quite sure exactly what you mean by goals regarding insurance AR. I am assuming by AR you mean Account Receivable?
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  3. #3
    Location
    Concord, NC or Rochester, NY
    Posts
    154
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    I use Days Sales Outstanding (DSO) as a measure for A/R. Then I review the pattern for each insurance carrier and set goals based on that. You may have to move the goals based on the performance. Suppose the insurance carrier is at 55 days today and you think it should be able to be maintained at 40, set the goal to improve and make it realistic and then move it down over time until you get the goal at 40 days.

    I am a CPA as well as CPC-I and hence this is a measure that is vital to a business.

    The last business I ran was a Multi-specialty surgery center and the average DSO including WC and Self pay was 25 days which means on average the A/R was collected in 25 days. Now each insurance carrier was different but there were goals that were reviewed monthly to ensure we were being efficient in collecting the A/R.

    I hope this brief explanation helps as this is where doctors usually get themselves in trouble.

    Another measure is the percentage of billed collected against a goal. This will help determine if claims are being written off when they should not be, etc.

  4. Default Thank you!
    Thank you - this information is exactly what I was looking for. I appreciate the help!
    Lana

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