Stop struggling with revenue cycle management challenges, turnover, and outstanding accounts receivable collections.
Did you know that $262 billion in medical claims are initially denied every year? It’s true! About 63% of the denied claims are recoverable, but it will cost your practice anywhere from $31.50 to $118 for each claim you have to reprocess. These accounts receivable losses can significantly impact your bottom line, as well as disrupt your revenue cycle workflow.
FOUR POTENTIAL OUTCOMES FOR BILLED CLAIMS
Unfortunately, 2, 3, and 4 occur for too many claims, and your practice has to engage in the onerous work of accounts receivable follow-up to address these underpaid and unpaid claims.
HOW DENIED CLAIMS IMPACT YOUR ACCOUNTS RECEIVABLE
Time-consuming and frustrating follow-up processes for denied claims, including:
- Generating reports on the status of individual accounts
- Performing denial follow up
- Reviewing payment discrepancies,
- Performing correction and rebilling activities
- Processing secondary billing
- Any necessary credit balance research and adjustments
Typically, 15-25% of cash collections are left on the table when these follow-up tasks are not completed or properly monitored.
Practices cannot afford long delays in outstanding receivables, as these payments are needed to pay expenses and to grow the company.
Revenue Cycle Challenges:
Here are just a few of the revenue cycle challenges that may be costing your practice thousands.
- Denials. Denied claims represent the highest financial exposure, as all costs have been incurred, but no payment has been collected. Plus, each denied claim usually costs you $15-20 per claim to handle the appeal, investigate, and then correct mistakes and rebill.
- Long Delays. More than 20% of all accounts receivable are over 90 days old. These delays continually cost your practice.
- Missed Deadlines. Payor guidelines for timely filing can be 90 or 120 days. If claims are not filed and/or corrected within those time frames, they may never be paid.
- Prioritizing. Some carriers’ timely filing guidelines are stricter than others. It can be difficult to know which carriers’ claims you should prioritize to avoid nonpayment due to timing.
|Key Performance Indicators
|Best Practice Standards
|Insurance A/R aged more than 90 days from service date
|Insurance A/R aged more than 180 days from service date
|Insurance A/R aged more than 365 days from service date
|Bad debt write-offs as a % of gross revenue
|Net AR days
LEGACY CONSULTING Accounts Receivable Services
We take those accounts receivable challenges and frustrations off your plate – and ensure you are paid for the services provided – with the following AR service options:
- Run detailed, aged outstanding accounts receivable reports and create custom accounts receivable worklists for your team. These worklists assign prioritized tasks to specific team members and track productivity.
- Provide payor and effective accounts receivable follow-up training to billers and collectors.
- Establish daily and weekly goals for the number of accounts to be worked.
- Provide custom accounts receivable reports, broken down by categories relevant to your specific needs (e.g., by practice, financial class, physician, payor).
- Create custom worklists for carriers based on filing limits so that cases are prioritized based on the length of timely filing limits.
- Offer revenue cycle tracking, including the number of accounts outstanding, number of accounts that have been worked, and the collections status and actions associated with these accounts.
How LEGACY CONSULTING differs from other RCM companies and the return on investment we deliver.
Our dedicated team has the experience and expertise to deliver better, faster accounts receivable management results. Here’s how we deliver unparalleled AR results to our clients.
- Consistently reduce insurance accounts receivable over 90 days from greater than 20% to less than 10%
- Dedicated accounts receivable team completes AR follow-up
- Maintain staffing levels sufficient to minimize/prevent aged A/R build-up
- Conduct regular quality control reviews of collectors’ work
- Cross-train our collectors on multiple one payor types
- Provide collector-specific worklist assignments, presented in descending balance order by payor
- Employ online, third-party payor inquiry systems
- Provide third-party/guarantor follow-up training and proven scripts to collectors
- Identify and promptly address underpayments and full denials at time of payment posting
- Set appropriate follow-up timeframes for each stage of follow-up on outstanding claims.
- Measure and routinely discuss collector quantity and quality of productivity with collectors.
- Review high dollar, high risk accounts and make recommendations.
- Track write-offs and approvals.
Contact the Legacy Consulting team today to inquire about a complete revenue assessment of your practice. Let us show you how we can improve your cash flow and your bottom line!
What Our Customers Have to Say
Going live on an EHR for the first time is a major undertaking. Switching from one EHR to another, however, is a whole new ballgame, and one for which there isn’t a ton of collective industry experience. Donna White and Jennifer Geoppinger led our practice confidently through the EHR selection and contract negotiation process to help ensure we were making the best decision for our present and future needs. Where they truly earned their keep, however, was in the implementation phase. They helped us construct a doable, yet aggressive, implementation timeline and made sure we stayed on track with no unexpected A/R delays. Their razor-sharp project management skills combined with their A/R management and technical knowledge were the ideal combination for our project. Since go-live, Jennifer remains involved in our team to make sure we are fully leveraging the investment we made.
Practice Administrator, Internal Medicine Associates
Our facility began using Legacy Consulting Services when we struggled with timely claims and denials in addition to little cash flow. From the beginning, our experiences with the staff have consistently been handled in a highly professional manner. Legacy has even taken the time to better educate our staff on appropriate processes for quicker payment turn around resulting in more cash flow for our facility. A consistent team from Legacy is the same team working our facility revenue items day in and out. This provides diligent support and attention to our accounts by the same people instead of a new person each day. Our facility has been able to lower our Accounts Receivable days to 25.
Physician Clinic Manager, Warren Memorial Hospital
What exactly is denials management? What are the benefits of tracking and managing your denials? Who should be tracking your denials rate? In today’s blog, we’re going to explore these questions. Denials Management Denials management is the process of reporting on received denials on a regular timetable, usually set by executive management. Be it weekly […]Read More
Many practices have their rejections and denials follow-up down to a fine art. But many may be leaving money on the table with their insurance and patient AR follow-up practices. Consider the following questions: How effective is your practice at collecting patient balances? Insurance balances? Do you have AR > 90 days less than 20%? […]Read More