How Lack of AR Management Can Harm Your Revenue in Hospitals?

Managing accounts receivable efficiently within a hospital or clinic is vital, as it ensures that patient’s good will and comfort is not compromised and dues are collected. While this appears to be simple, many providers do a shoddy job of it and on top of everything over 55% of patients who are not insured end up getting a bill that they simply cannot afford to pay. Here we look at some of the points that result in the bad accounts receivable management and claims being written off, and how they can be resolved by hospitals that choose to outsource the process.

Inadequate Monitoring of Accounts Receivable

Failing to keep track and analyze accounts receivables is something that most healthcare providers are guilty off. Importantly to get analysis right, employees need experience in account receivables, knowledge about the claim adjudication process, and familiarity with terms, coding and more.

Inability to Quickly Track Status of Claims

Tracking the status of claims and monitoring any changes to regulations is something that providers do not handle well, however it is easy when using a system designed for the purpose. Additionally, tools for data mining and trend identification along with comprehensive reports need be used to improve the handling of accounts receivable and access to these can be got when you outsource account receivable services to experts.

Failure to Calculate Financial Responsibility Ahead Of Time

Calculating financial responsibility for treatment or procedures ahead of time is something that 49% of all providers fail to do. These providers just do not have the software or processes in place to calculate patient financial responsibility until a claim is submitted and processed. Also as most providers focus on copayments and not insurance eligibility verification, consequently the billing department has to struggle to get the accounts receivable process finished within 42 days.

Not Offering Pre-payment Plans or Loans

Paying ahead of time for treatment based on estimates is another tactic being offered by some providers. Information about prepayment plans and no-interest loans are most effective when they are created well ahead of time and delivered to the patient along with pre-surgery details and it results in less defaults and increased good will.

Using Outsourcing Partners who are Unfamiliar with Self-Pay Accounts

Partners who are familiar with setting up and handling self-pay accounts, allow for better management of accounts receivable and patients can pay small monthly amounts instead of larger installments. This tactic reduces stress placed on the patient during the repayment, and ensures they pay the full amount that is due to the provider.

Late Management of Denials

Aiming for resolution of 37% claims or more at the first instance should be the goal of any hospital or clinic. However, in case this does not happen denials should be managed within the quickest possible time as rejections handled with a 48-hour period result in about 80 percent of claims being resolved within a 90-day period.

Keeping patients happy with the treatment provided in a hospital and clinic is a high priority and is going to get more emphasis under the value-based care system. Efficiently managing accounts receivable and ensuring patient good will is something that we at OutsourceRCM are geared to get right. Get in touch with us if you want to learn how to deal with bad patient debt which was pegged at $36 billion in 2015 and continues to mount.

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