Healthcare providers lose 5-15% of annual revenue because of improper AR (accounts receivable) management. A report published by the Medical Group Management Association (MGMA) found that the average AR days for over 13% of healthcare providers is 120 days.
Most healthcare providers need help managing their AR and collecting their payments on time. In this article, our experts with 15+ years of experience have explained tips, tricks, and the importance of AR management.
Blog index:
- Definition of AR management in Healthcare RCM
- Importance of AR management
- Stages of AR management
- Efficient AR management tips
Definition of AR management in Healthcare RCM
Tracking and collecting payments from patients and payers for the healthcare services offered is called AR management. It is advised that the average AR for a healthcare organization should be <25 days.
Here are the steps involved in AR management:
- The first and most important step in accounts receivable management is verifying patient insurance coverage. Verification helps to understand the current insurance status of the patient.
- Healthcare providers need to submit error-free claims the first time. Claim scrubbing and submitting error-free claims is the next step that plays a vital role in AR management.
- Following up with payers and patients is crucial as cash flow directly depends on how well you get engaged with your patients and payers.
- Denials can hamper the revenue of the healthcare provider. Managing your denials is vital to manage your account receivable.
- Analyzing the reports and payments is important for healthcare providers as it will give a clear idea of what payments need to be collected.
Importance of AR management
The financial health of the healthcare provider depends on how well they manage the AR. AR management is important to streamline the cash flow from the patient's call for an appointment until the final payment is received. Here are a few other reasons why AR management is important:
- Smooth cash flow
- Revenue optimization
- High patient satisfaction
- Compliance
Stages of AR management
AR management can happen primarily in 3 stages. Each stage needs to be followed properly to get the desired results.
Stage 1: Pre invoice
- Credit check conduction
- Payment term establishment
- Setting up a patient account
Stage 2: Invoicing
- Accurate invoice generation
- Prompt invoice delivery
- Unpaid claim follow-up
Stage 3: Payment & collections
- Collect payments
- Resolve denials
- Reconciliation
Efficient AR management tips
Efficient AR management ensures timely payment and minimizes write-offs. Here are a few tips to efficiently manage AR.
- Patient insurance eligibility verification
- Precise coding
- Claim scrubbing and submission
- Following up on outstanding payments
- Check denials and appeal status
- Create payment plans
- Appropriate staff training
AR management can be done in-house or outsourced to providers like Plutus Health, with years of experience serving the healthcare industry. Outsourcing helps to take off the burden from the internal staff and helps to collect payment on time.
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