Turning Revenue into Cash: The Importance of AR Follow-up and Timely Filing

Donna White

Donna White

By Donna White, Principal Consultant and Owner of Legacy Consulting Services and Legacy Billing Solutions in Montgomery, Alabama.

In the intricate landscape of healthcare, managing the revenue cycle and reimbursement is a constant challenge for practices. Timely filing of claims and timely AR follow-up is a pivotal aspect that directly impacts cash flow. Failure to adhere to timely filing limits and appeal deadlines set by different payors can lead to significant financial losses for healthcare practices. 

It’s more important than you think. It can be the difference between being profitable and not being profitable.  

In this blog, we discuss the risks associated with missing timely filing and appeal deadlines and explore how Legacy Consulting Services assists practices in avoiding revenue loss through dedicated Accounts Receivable (AR) follow-up teams or custom AR worklists.

Understanding Timely Filing

Timely filing refers to the practice of submitting medical claims to insurance payors within a specified timeframe. Each payor sets its deadlines, typically ranging from 90 to 180 days and sometimes a year from the date of service. In addition, each payor will have an appeal deadline by which any denied claim must be appealed if originally denied for some reason. Failing to submit claims within these deadlines can result in denials, leading to revenue loss for healthcare practices.

Risks of Missing Timely Filing Deadlines

  • Claim Denials: The primary risk is the denial of claims due to late submission. Payors strictly enforce timely filing limits, and any deviation can result in automatic claim rejection.
  • Revenue Loss: Denied claims translate directly into revenue loss for healthcare practices. The financial impact can be substantial, affecting cash flow and hindering the overall financial health of the organization.
  • Administrative Burden: Re-submitting denied claims involves additional administrative work, leading to increased costs and resource allocation. This diversion of resources from core patient care activities can impact overall efficiency.
  • Potential Legal Consequences: Some payors may refuse to reimburse for services rendered if claims are not submitted within the stipulated time frame. This not only results in financial loss, but can also lead to legal complications.

Legacy’s Approach to Timely Filing and Revenue Loss Prevention

Legacy understands the intricacies of healthcare revenue management and has developed a comprehensive strategy to mitigate the risks associated with missing timely filing limits. One key component of Legacy’s approach is the implementation of custom AR follow-up worklists.

1. Customized Worklists: Legacy tailors custom AR follow-up worklists out of your practice management system by office, by the payor and with considerations for timely filing deadlines, age, and dollar amount of the claims. This ensures that attention is focused on the most critical and time-sensitive claims and ultimately yields more cash for the practice.  

2. Proactive Follow-up: Legacy’s team of experienced professionals proactively follows up on outstanding claims, identifying potential issues and resolving them before they escalate. This approach significantly reduces the likelihood of denials due to late submissions or unpaid claims sitting on the accounts receivable for an indefinite period of time, leading to write-offs. 

3. Technology Integration: Legacy assists with the implementation of streamlined claims submission processes, tracking of accepted and rejected claims as well as denials tracking. This technology will be dependent upon the practice management system and clearinghouse that are utilized.

4. Educational Support: Legacy provides ongoing education and training to healthcare practice staff, keeping them informed about the latest revenue cycle trends, industry updates, payor policies, and reimbursement guidelines.  Timely filing is a critical element in the revenue cycle of healthcare practices. The risks associated with missing filing deadlines are multifaceted, impacting not only financial outcomes but also the overall operational efficiency of the organization. Contact us today to help you navigate the complexities of revenue management.

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