AR follow up medical billing collects payment on outstanding claims. Your practice submits claims to insurance companies. However, not all claims get paid automatically. Therefore, follow-up work is essential for revenue collection.
Your accounts receivable represents money owed to your practice. Some claims are paid quickly within 30 days. Meanwhile, other claims require persistent follow-up. Thus, systematic follow-up processes convert AR into actual cash.
This guide explains the complete ar follow up process in medical billing. First, you will learn what AR follow-up includes. Next, you will discover prioritization strategies. Finally, you will understand how follow-up improves cash flow.
Most practices struggle with growing accounts receivable balances. However, proper follow-up procedures reduce AR significantly. In fact, effective follow-up can decrease AR by 30 to 40 percent. Therefore, your practice needs strong follow-up workflows.
What Is AR Follow-Up
AR follow-up tracks unpaid insurance claims after submission. Your team contacts insurance companies about outstanding balances. Additionally, they investigate why claims remain unpaid. Therefore, follow-up turns submitted claims into collected revenue.
The accounts receivable follow up process begins after expected payment timeframes pass. For example, most clean claims pay within 30 days. However, claims unpaid after 30 days need investigation. Thus, follow-up identifies and resolves payment delays.
When Follow-Up Begins
Follow-up timing depends on payer and claim type. For instance, electronic claims typically pay within 14 to 21 days. Meanwhile, paper claims take 30 to 45 days. Therefore, your follow-up schedule should reflect these timeframes.
Most practices start follow-up after 30 days for electronic claims. Additionally, they begin at 45 days for paper claims. However, high-value claims may warrant earlier follow-up. Thus, claim amount affects follow-up timing.
Standard Follow-Up Timeframes
Your practice should establish standard follow-up schedules. First, check claims at 30 days if unpaid. Next, follow up again at 45 days. Then, escalate at 60 days if still unpaid. Finally, pursue aggressively at 90-plus days. Therefore, consistent timing ensures no claims are forgotten.
Some payers have slower payment cycles. For example, government payers may take longer. Additionally, workers compensation claims have extended timeframes. Therefore, payer-specific schedules improve efficiency.
Your staff should document every follow-up attempt. This documentation shows persistence. Additionally, it provides evidence for appeals. Therefore, detailed records support collection efforts.
Components of Effective Follow-Up
Effective ar follow up medical billing includes multiple activities. First, staff identify unpaid claims systematically. Next, they contact payers through appropriate channels. Then, they document all communications. Finally, they take necessary next actions. Therefore, comprehensive follow-up maximizes collections.
Your team uses various contact methods during follow-up. For instance, they call payer claims departments. Additionally, they submit electronic status inquiries. Moreover, they send written correspondence when needed. Thus, multiple channels increase response rates.
Documentation Requirements
Every follow-up contact must be documented thoroughly. For example, record the date and time of contact. Additionally, note the representative’s name. Moreover, document what information was provided. Finally, record any promises or next steps. Therefore, complete documentation tracks progress.
Your practice management system should store all follow-up notes. This centralized documentation helps all staff members. Additionally, it prevents duplicate follow-up efforts. Therefore, system documentation improves efficiency.
Follow-up notes should include specific details. For instance, record claim status according to the payer. Additionally, note payment dates if provided. Moreover, document any additional information requests. Thus, detailed notes guide next actions.
AR Aging and Prioritization
AR aging categorizes outstanding balances by age. Your aging report shows how long claims have been unpaid. Additionally, it helps prioritize collection efforts. Therefore, aging analysis is essential for follow-up.
Your accounts receivable ages in specific categories. Typically, reports show 0-30 days, 31-60 days, 61-90 days, and 90-plus days. Additionally, each category requires different follow-up approaches. Therefore, understanding aging guides your strategy.
Understanding AR Aging Reports
AR aging reports organize unpaid claims by age brackets. For example, the 0-30 day category includes recently submitted claims. Meanwhile, the 90-plus day category shows long-outstanding balances. Therefore, aging reveals collection problems quickly.
Your practice should review aging reports weekly at minimum. This frequency catches problems early. Additionally, regular review prevents claims from aging excessively. Therefore, consistent monitoring improves results.
Healthy AR Aging Benchmarks
Industry benchmarks suggest specific aging distributions. For instance, 0-30 days should contain 50 to 60 percent of AR. Additionally, 31-60 days should hold 20 to 25 percent. Moreover, 61-90 days should represent 10 to 15 percent. Finally, 90-plus days should stay under 10 percent. Therefore, these benchmarks guide performance goals.
Your practice should track aging trends over time. For example, compare current month to previous months. Additionally, identify which categories are growing. Therefore, trend analysis reveals emerging problems.
Some specialties have different benchmark ranges. For instance, surgical practices may have higher percentages in later categories. However, all practices should minimize 90-plus day balances. Therefore, specialty-specific benchmarks provide better comparisons.
Prioritizing Follow-Up Work
Not all outstanding claims deserve equal attention. For instance, high-dollar claims need immediate follow-up. Meanwhile, small-balance claims may wait. Therefore, strategic prioritization maximizes collection value.
Your staff should consider multiple factors when prioritizing. First, evaluate claim age. Next, assess claim amount. Then, consider payer payment patterns. Finally, review previous follow-up attempts. Therefore, systematic prioritization focuses effort effectively.
High-Priority Claim Characteristics
Certain claims should receive immediate attention. For example, claims over $1,000 are high priority. Additionally, claims in 90-plus days need urgent work. Moreover, claims with upcoming filing deadlines require fast action. Therefore, these characteristics trigger immediate follow-up.
Your team should create daily work queues. These queues list high-priority claims first. Additionally, they organize work by payer or claim type. Therefore, structured queues improve productivity.
Some payers have specific follow-up windows. For instance, corrected claims must be submitted within certain timeframes. Additionally, appeal deadlines are strict. Therefore, deadline awareness prevents lost revenue.
Low-Priority Claims Management
Small-balance claims receive lower priority. For example, claims under $50 may not justify extensive effort. However, they still need follow-up eventually. Therefore, batch processing works well for small claims.
Your staff can group small claims by payer. Then, they follow up on multiple claims in one call. Additionally, automated status inquiries work well for small balances. Therefore, efficient methods reduce follow-up costs.
Some practices set minimum follow-up thresholds. For instance, claims under $25 receive only one follow-up attempt. However, this approach should consider overall impact. Therefore, balance efficiency against revenue loss.
AR Follow-Up and Cash Flow
AR follow up medical billing directly impacts your cash flow. Specifically, effective follow-up accelerates payment collection. Additionally, it reduces money tied up in receivables. Therefore, follow-up is critical for financial health.
Your practice needs consistent cash flow for operations. For example, payroll must be met every period. Additionally, rent and supplies require regular payment. Therefore, collecting AR maintains operational stability.
Reducing Days in AR
Days in accounts receivable measures collection speed. This metric shows average days from service to payment. Additionally, lower numbers indicate better performance. Therefore, effective follow-up reduces days in AR.
Industry benchmarks suggest keeping days in AR below 50. However, many practices operate at 60 to 90 days. Therefore, significant improvement opportunity exists. Moreover, even small reductions improve cash flow substantially.
Calculating Days in AR
Your practice can calculate days in AR easily. First, divide total AR by average daily charges. For example, $300,000 AR divided by $10,000 daily charges equals 30 days. Therefore, this calculation shows collection speed.
Your days in AR should trend downward over time. For instance, compare current quarter to previous quarters. Additionally, identify factors causing increases. Therefore, trend monitoring supports continuous improvement.
Some practice management systems calculate this automatically. Additionally, they track trends over time. Therefore, technology simplifies performance monitoring.
Improving Collection Percentage
Collection percentage shows how much you collect versus how much you bill. For example, collecting $95,000 on $100,000 billed equals 95 percent. Therefore, higher percentages indicate better performance.
Effective ar follow up process in medical billing improves collection percentages. Specifically, persistent follow-up recovers more outstanding claims. Additionally, it prevents write-offs from aged accounts. Therefore, follow-up directly increases collections.
Collection Rate Benchmarks
Industry benchmarks suggest 95 to 98 percent collection rates for insurance. However, many practices collect only 85 to 90 percent. Therefore, 5 to 10 percent of revenue is lost. Moreover, better follow-up recovers much of this loss.
Your practice should track collection rates by payer. For instance, some payers pay better than others. Additionally, this tracking identifies problematic payers. Therefore, payer-specific analysis guides strategy.
Patient collection rates are typically lower than insurance rates. For example, practices collect 50 to 70 percent of patient balances. However, follow-up still improves patient collections. Therefore, accounts receivable follow up applies to all balance types.
Preventing Write-Offs
Write-offs represent permanent revenue loss. Your practice writes off balances considered uncollectable. However, aggressive follow-up prevents many write-offs. Therefore, follow-up protects revenue.
Common write-off reasons include aged accounts and small balances. For instance, claims over 120 days are often written off. Additionally, balances under $10 may be deemed not worth pursuing. Thus, timely follow-up prevents aging to write-off stages.
Write-Off Policies
Your practice should have clear write-off policies. For example, specify when accounts can be written off. Additionally, require management approval for write-offs. Therefore, policies prevent premature revenue loss.
Some write-offs are unavoidable. For instance, patient bankruptcies eliminate collection possibility. Similarly, deceased patients without estates cannot pay. However, most write-offs result from inadequate follow-up. Therefore, strengthening follow-up reduces write-offs.
Your write-off rate should stay below 2 to 3 percent. Higher rates indicate collection problems. Additionally, they suggest follow-up improvements are needed. Therefore, write-off tracking guides process changes.
Follow-Up Methods and Strategies
Effective AR follow up uses multiple communication methods. For instance, phone calls work well for complex situations. Meanwhile, electronic inquiries handle simple status checks. Therefore, method selection affects efficiency.
Your team should match methods to claim characteristics. For example, high-value claims warrant phone follow-up. However, routine status checks can be automated. Thus, strategic method selection optimizes results.
Phone Follow-Up Best Practices
Phone calls remain the most effective follow-up method. Specifically, calls allow real-time problem solving. Additionally, they build relationships with payer representatives. Therefore, phone follow-up achieves better results.
Your staff should prepare before making calls. For instance, gather all relevant claim information. Additionally, review previous follow-up notes. Moreover, identify specific questions to ask. Therefore, preparation makes calls more productive.
Effective Call Techniques
Successful follow-up calls follow specific patterns. First, identify yourself and your practice clearly. Next, provide the claim number and patient information. Then, ask specific questions about claim status. Finally, document all responses carefully. Therefore, structured calls get better information.
Your staff should remain professional and persistent. For example, stay polite even when frustrated. Additionally, ask for supervisors when needed. Moreover, request specific payment dates. Thus, professionalism and persistence improve results.
Some payers have specific call center procedures. For instance, certain information must be provided first. Additionally, some questions have scripted answers. Therefore, understanding payer processes improves efficiency.
Electronic Status Inquiries
Electronic status inquiries check claim status automatically. These systems query payer databases directly. Additionally, responses arrive within hours or days. Therefore, electronic inquiries save phone time.
Most clearinghouses offer status inquiry services. Your practice submits inquiry files electronically. Then, payers respond with claim status information. Therefore, electronic methods handle high volumes efficiently.
When to Use Electronic Inquiries
Electronic inquiries work well for routine follow-up. For example, checking if claims were received. Additionally, confirming claims are in process. Therefore, simple status checks use electronic methods.
Complex situations still need phone follow-up. For instance, denied claims require detailed discussion. Similarly, missing information requests need clarification. Therefore, electronic inquiries supplement phone work.
Your practice should use electronic inquiries for initial follow-up. Then, escalate to phone calls if needed. Additionally, track which claims need phone attention. Therefore, layered approaches maximize efficiency.
Written Follow-Up Communication
Written follow-up includes letters and faxes. These methods create formal documentation. Additionally, they work well for appeals. Therefore, written communication serves specific purposes.
Your practice should use written follow-up strategically. For instance, formal appeals require written submissions. Additionally, some payers prefer written documentation. Therefore, understanding payer preferences guides method selection.
Appeal Letters and Documentation
Appeal letters must be professional and complete. First, clearly state the claim information. Next, explain why payment is appropriate. Then, attach supporting documentation. Finally, reference specific policy provisions. Therefore, complete appeals have better success.
Your appeals should include deadlines for response. For example, request response within 30 days. Additionally, indicate next steps if appeal is denied. Therefore, clear expectations encourage timely responses.
Some appeals benefit from provider involvement. For instance, physician letters support medical necessity appeals. Additionally, clinical explanations strengthen complex cases. Therefore, provider participation improves appeal success.
Technology in AR Follow-Up
Technology dramatically improves ar follow up medical billing efficiency. Specifically, automated systems track follow-up requirements. Additionally, they create work queues automatically. Therefore, technology enables better follow-up.
Your practice management system should support follow-up activities. For example, it should generate aging reports automatically. Additionally, it should track follow-up attempts. Therefore, system capabilities affect follow-up effectiveness.
Work Queue Management
Automated work queues organize follow-up tasks. Your system identifies claims needing follow-up. Additionally, it prioritizes based on your criteria. Therefore, staff always know what needs attention.
Work queues save significant time. For example, staff do not manually search for aged claims. Instead, the system presents prioritized lists. Therefore, productivity increases substantially.
Queue Configuration
Your queues should reflect your prioritization strategy. For instance, create separate queues for different age brackets. Additionally, organize by payer or claim amount. Therefore, customized queues match your workflow.
Staff should work queues systematically. For example, complete high-priority queues first. Additionally, track completion rates. Therefore, queue discipline ensures consistent follow-up.
Some systems allow multiple queue views. For instance, staff see claims by payer or by age. Additionally, supervisors monitor overall queue sizes. Therefore, flexible views support different roles.
Automated Reminders and Alerts
Automated reminders prevent missed follow-up opportunities. Your system alerts staff when claims need attention. Additionally, reminders trigger before deadlines approach. Therefore, automation ensures timely action.
Reminders should be specific and actionable. For example, “Claim 12345 needs 60-day follow-up today.” Additionally, include relevant claim details. Therefore, staff can act immediately.
Escalation Triggers
Your system should escalate claims automatically. For instance, claims unpaid at 90 days trigger supervisor alerts. Additionally, high-value claims get escalated earlier. Therefore, automatic escalation prevents oversights.
Escalation should prompt specific actions. For example, 90-day claims may require appeal preparation. Additionally, 120-day claims might need write-off review. Therefore, escalation triggers appropriate responses.
Management should review escalation reports regularly. This review identifies systemic problems. Additionally, it ensures escalated claims receive attention. Therefore, oversight supports effective follow-up.
Reporting and Analytics
Follow-up reporting tracks performance and identifies trends. For example, reports show follow-up volume by staff member. Additionally, they reveal payer-specific patterns. Therefore, analytics guide improvement efforts.
Your reports should track key follow-up metrics. For instance, number of follow-up attempts per claim. Additionally, time from follow-up to payment. Therefore, metrics reveal process effectiveness.
Performance Metrics
Common follow-up metrics include resolution rate and time to resolution. Resolution rate shows what percentage of followed-up claims get paid. Meanwhile, time to resolution measures days from follow-up to payment. Therefore, both metrics indicate effectiveness.
Your practice should benchmark metrics over time. For example, compare monthly resolution rates. Additionally, identify improving or declining trends. Therefore, trend analysis supports continuous improvement.
Staff performance tracking helps manage teams. For instance, compare resolution rates between staff members. Additionally, identify training needs. Therefore, individual metrics support development.
Strengthen Your AR Follow-Up
AR follow up medical billing requires persistence and organization. Additionally, effective follow-up accelerates cash flow significantly. Therefore, your practice needs systematic follow-up processes.
However, managing follow-up with high claim volumes is challenging. Additionally, tracking multiple payers and deadlines is complex. Furthermore, your staff must balance follow-up with other duties. Thus, many practices struggle with AR management.
HS MED Solutions specializes in accounts receivable follow up for medical practices. Experienced collection specialists handle your complete follow-up process. Therefore, your AR decreases while cash flow improves.
Expert teams work your outstanding claims systematically. Additionally, they use multiple follow-up methods strategically. Moreover, they escalate appropriately when needed. Therefore, collection rates increase substantially.
Advanced tracking systems monitor every outstanding claim. For instance, automated work queues prioritize daily activities. Additionally, reminder systems prevent missed follow-ups. Therefore, no claim falls through the cracks.
Practices working with HS MED Solutions see dramatic improvements. For example, days in AR decrease by 20 to 30 days typically. Additionally, collection percentages increase by 5 to 10 percent. Therefore, your practice collects significantly more revenue faster.
Contact HS MED Solutions today to learn how professional AR follow-up transforms your ar follow up process in medical billing and maximizes your practice revenue.
One Response
Keep functioning ,impressive job!