- Patient upfront collections - Are patients paying for their services before surgery?
- Documentation - Are operative notes being dictated on the same day of surgery? Are pathology notes, implants invoices, and queries being follow up on quickly?
- Claims process - Are claims being coded, entered, and billed within a timely manner from the date of service (48 hours)?
Let’s look at the very first step of getting days in AR down, Patient upfront collections. The hard truth is no one likes asking for money. Each patient will present with a different demeanor when the front desk is asking to collect the co-pay, deductible and/or coinsurance. Having a consistent payment policy will not only help the staff when talking to patients but will keep your Days in AR down. (See Blog: Is Your Center Consistent When Collecting Patient Payments?) It’s helpful to work with patients and be flexible, but remember your ASC is not a lending service. However, there are lending services available! Consider referring patients to an independent financial solution like Smart Health Pay Card. This credit card (backed by Mastercard) ensures facilities receive 100% of the funds paid to your center by the patient. Another huge help in collecting is making sure proper insurance verification is done at least 2 weeks before surgery (See: Insurance Verification Checklist). Providing your patients a proper estimate gives them time to review payment options and adhere to your policy.
Document, document, document! Documentation is key when coding a case and getting it sent to insurance companies. Operative notes must quickly be dictated. Pathology reports and implant invoices must quickly be available. The coding team will need all information to ensure maximum reimbursement for the case. Once coding is received, how quickly are those charges getting to the insurance company? Industry standard is a 48 hour turnaround time from date of service.
The claims process is going to be the most important part once everything is received. You don’t want all of your hard work collecting patient payments and documents to go to waste while a claim sits unbilled. After everything has been submitted, who is following up on that claim? If you are you waiting until you receive something from the insurance company (Ex: payment, denial, rejection), you may be waiting too log. Consider assigning someone to status billed claims and ensure proper receipt. At the same time, check with the carrier to see if any additional documentation is needed. These steps are key in making sure you are being proactive and not reactive in collecting payments.
Your Days in AR is a great indicator of the overall health of your billing process. Therefore, in2itive uses Days in AR as one way to grade the entire revenue cycle process. We utilize at least six team members on our Full Service Clients who all work on collecting money quick and efficiently. Our trained Patient Service Representatives can review balances due prior to surgery and review payment arrangements to reduce post-procedure AR follow up. Our Medical Billing Specialists keep a record of what operative notes, pathology reports, implant invoices, and queries are missing for completion of coding. This process ensures no cases fall through the cracks, or sit for weeks prior to billing. in2itive monitors for timely filing and provides monthly reporting on unbilled charges. We do all of this to ensure claims are out the door as quickly as possible and followed up on within the first 15 days. Staying proactive and data driven allows us to keep days in AR down and improve the overall success of our clients.
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