Healthcare Accounts Receivable Management Services
“Our expert services aid healthcare providers in lowering their AR Follow up timelines by proactively addressing any delays that may arise. We ensure a thorough understanding of the underlying reasons behind these delays and promptly follow-up with both insurance companies and patients. This not only helps in streamlining the A/R process, but also ensures clear communication and transparency.”
Scope of our Healthcare Accounts Receivable Follow-up Services
Soho Tech Services deploys a team of seasoned accounts receivable follow-up specialists who work on the following areas:
Follow-up with insurance companies:
We utilize various communication channels such as websites, fax, IVR, and phone to ensure accurate updates on claims status. Our focus also extends to working with provider clients to encourage the use of websites as a primary means of contact.
Develop policies and procedures for A/R follow-up:
We have implemented effective policies and procedures. By closely monitoring the aging bucket of our A/R, we are able to determine when payers should have the necessary information and proactively initiate follow-up calls at the appropriate time following submission.
Automation:
Our company is proud to provide automation services that allow for seamless access to payer websites and the ability to effortlessly generate queries and
retrieve claim status information. This practical approach streamlines the process and saves time.
Effective action plan:
We take it a step further by enacting an effective action plan, including advocating for refiled claims and appeals to ensure reimbursements are received. We also prioritize analytics to reduce the days in accounts receivable, providing our clients with a well-rounded solution.
Track Status
Follow up with the insurance company to track the status of the claims.
Identify Denial Issues
We identify denied claims, to analyze the reasons, follow-up with insurance company to check if additional information is needed and address the issues.
Refile the Claim
Refile the corrected claim to the insurance company and initiate follow up plan. At times, we may need to bill the secondary insurer.
Resolve the Claim
Track the status of the claim with the insurer and follow-up till the claim is resolved.
Accounts Receivable Clearance Projects:
Hospitals, physicians, and medical practices have all faced their fair share of challenges when it comes to managing old accounts receivable. Issues such as staffing shortages, inadequate write-off policies, and ineffective closures have caused a buildup of insurance claims worth millions of dollars in aged A/R. At our company, we specialize in clearing A/R backlogs through a comprehensive process that includes:
Assessment:
Our process for assessing claim quality involves categorizing claims based on factors like aging, payer group, and timely filing challenges, as well as the type of player. This thorough analysis allows us to gain insight into the overall quality of our accounts receivable, identify collectible amounts that require a final review, and accurately evaluate the remaining accounts before transferring them to collections agencies.
Develop Guidelines:
One of the major causes of messy A/R situations can often be traced back to a lack of clear policies regarding write-offs and negotiations with insurance companies. This can be attributed to changes in leadership at the healthcare provider’s office, as well as a lack of established procedures and policies. However, when our team takes on an A/R backlog clearance project, we are able to provide a solution.
Through our services, we work closely with healthcare providers and our billing company clients to establish collection goals, define the negotiation process, and determine the appropriate number of attempts before deeming a claim uncollectible. This ensures a more efficient and streamlined approach to A/R management.
Retrieving Associated Clinical documentation:
Clearing up A/R backlog is typically due to changes in the system. However, if a proper process for retrieving clinical documentation is not in place, the collection process may not be as effective due to the absence of necessary documentation.
Benefits of the Accounts Receivable Process with Soho Tech Services
Our full suite of A/R and denial management services offers our clients the following benefits:
- Focus on getting claims resolved. We focus on fixing the claims rather than merely obtaining the status of the claims.
- Reducing work effort. By increased adoption of technologies such as web portals for checking claims status, we act upon opportunities to reduce efforts to check claims status manually.
- Workflow automation. Each claim status code requires a set of questions to be answered by insurance companies to resolve the claim effectively. We have defined our claims follow-up work queues with web-based workflow systems that improve the documentation quality.
- Dashboards and metrics. We generate multi-variate reports to get a clear view of the A/R and focus our efforts on resolving.
- Improved collections and reduction of days in A/R. Our clients see a 20% reduction in days in A/R and improved collections by about 5-7%.
We also provide denial management services. For more details, please visit our page.