AR Recovery Process - Challenges and Solutions

Recovering outstanding payments from insurance companies is a challenging task for healthcare providers. Similarly, getting paid for every rendered service is essential to maintaining positive cash flow and a streamlined revenue cycle. Managing claim denials to reduce the accounts receivable days requires an effective AR recovery process in healthcare billing. In addition, unpaid and denied claims pose a threat to the financial stability of a medical practice. That’s why efficient AR recovery is essential to stay on top of the revenue cycle process.

To avoid aging accounts receivable, medical practices must keep track of payments and create an error-free claim submission process. Likewise, continuous follow-up with payers is required to ensure timely reimbursements. Further, practices must inform patients about their financial responsibility to optimize net collections and improve the bottom line. Addressing revenue cycle concerns needs time and attention as it directly impacts a medical practice’s earnings.

Challenges in the AR Recovery Process

To keep the AR recovery streamlined, healthcare providers should be aware of the following challenges:

Claim Denials and Rejections

Denials and rejections are major hindrances to maintaining a high-performing revenue cycle. Similarly, mistakes in medical coding, not knowing the medical necessity, and errors in patient information lead to claim rejections. Also, providers and healthcare staff need to keep the paperwork sufficient and accurate. So, resolving claim denials can be a time-consuming process, and it requires rigorous follow-ups and appeals.

Incorrect Patient Information

Another challenge in the AR recovery process is entering incorrect patient information while submitting medical claims. Likewise, medical practices cannot get timely payments if they submit claims with inaccurate information. Further, outdated patient contact information disrupts the revenue cycle process.

Complex Payer Policies

Every insurance payer has guidelines for providers when it comes to claim submissions. Similarly, the billing staff must follow the payer rules to receive timely reimbursements. In addition, multiple payers are involved in paying healthcare providers, so following every payer’s guideline is essential.

Meeting Compliance Requirements

Healthcare staff must adhere to HIPAA and other industry rules to stay compliant and avoid penalties. Medical practices need to find compliance issues to optimize the recovery of outstanding payments. Thus, medical practices should proactively deal with claims processing to ensure that they meet every requirement in the first place.

Trained Healthcare Staff

To ensure a seamless AR recovery process, providers need experienced staff knowledgeable about coding and billing. Similarly, medical practices must train their staff or outsource medical billing to professionals. Further, hiring and training staff is costly, so submitting clean claims is essential to reducing revenue leakages.

How to Improve AR Recovery Process in Healthcare Billing

Communicating with Patients About their Financial Responsibility

Surprise bills are frustrating for the patients. The healthcare staff needs to communicate with the patients about their financial responsibilities. Likewise, managed care plans include some payments that patients need to pay. So, informing patients about their financial obligations is essential to collecting complete payments for medical services.

The best way to minimize confusion and frustration is to inform patients about their financial responsibility before the treatment. As a result, providers can reduce the stress of losing money and get paid for every service.

Collect Copayments and Deductibles Upfront

One of the best ways to reduce the hassle of the AR recovery process is to collect upfront costs from patients. Likewise, providers can request patients to pay their part before rendering medical services. This helps medical practices reduce outstanding payments. So, collecting payment from patients in the beginning is better than getting it later.

Healthcare staff can implement asystem of sending automated reminders about their payments. In this way, patients know exactly what they must pay when visiting your clinic. However, if the patient cannot initially pay for services, you can discuss it.

Spend Ample Time to Submit Error-Free Claims

The best way to reduce denials and rejections is to spend time and attention submitting medical claims. In addition, it reduces the accounts receivable and helps achieve seamless claims processing. Also, it minimizes the negative impact on the revenue cycle process and saves you time and resources. Here are some ways to achieve a clean claim submission process:

Use precise CPT, ICD-10, and HCPCS codes for claim submission.
Check the medical necessity before offering medical services.
Verify the eligibility of patients’ benefits beforehand.
Enter 100% correct information of the patients.
Follow payer-specific guidelines to avoid denials.

The Takeaway

An efficient AR recovery process requires expertise and time to execute. Similarly, providers need to take a proactive approach to submitting claims. This is the best way to prevent claim rejections and reduce the denial rate. Also, recovering payments from patients and payers requires time and effort. Therefore, collecting payments from patients before rendering services can reduce accounts receivable. Implement best practices while submitting claims to get reimbursements.