Unlocking The Potential Of Accounts Receivable In Medical Billing

Medical billing companies or healthcare organizations usually struggle with AR management. Too often, tasks related to sending invoices and tracking payment due need to be noticed or squeezed into an already jam-packed schedule. This can result in invoices missing their deadlines or lost payments - needless logistical headaches that you don't need! 

Say goodbye to missed deadlines, mismanaged patient portals, lost payments, and tedious manual processing: with Enter. Health's reliable billing solution. Our medical billing specialists can help you along your billing process and ensure that invoices are sent out efficiently, payments are tracked easily, and revenue is maximized.

What Are Accounts Receivable In Medical Billing?

Accounts receivable in medical billing refers to the money that a healthcare provider owes patients or insurance companies for services rendered. This refers to the outstanding payments that have been billed but have yet to be collected. 

Importance Of Accounts Receivable In Medical Billing

Accounts receivable (AR) plays a crucial role in the financial health of healthcare providers and is an essential component of medical billing. The importance of AR in medical billing can be summarized as follows:

Cash Flow Management

AR is an essential factor in managing cash flow for healthcare providers. Accurate and timely billing and collection of payments from an insurance company and patient are critical to maintaining a stable cash flow.

Revenue Cycle Management

AR is an essential part of the revenue cycle management process. Accurate and efficient billing and collection practices ensure that healthcare providers are able to maximize their revenues while minimizing the risk of bad debt.

Financial Stability

Healthcare providers can increase their financial security and lower their risk of financial stress by handling accounts receivable (AR) well. To increase profitability and lower bad debt, you must have accurate invoicing, prompt payment collection, and good AR management procedures.

Accurate billing is key to ensuring that healthcare providers receive payment for services rendered. This includes ensuring that all documentation is accurate and complete, that the billing code used is appropriate for the service provided, and that all insurance information is up-to-date.

Timely collection of payments is also essential to keeping accounts receivable healthy. By setting up clear payment plans with patients and following up regularly to collect overdue payments, healthcare providers can easily track the information.

Quality Of Care

Effective accounts receivable management is critical for healthcare providers, as it helps to free up resources to invest in quality patient care. Poor AR management can directly impact a provider's financial health, resulting in lower profits and higher bad debt. On the other hand, effective AR management can help to maintain a cleaner accounts receivable balance, reducing financial strain and freeing up resources to invest in quality patient care.

Compliance

According to a number of rules, including the Health Insurance Portability and Accountability Act, medical professionals must maintain accurate and secure records. Effective AR management improves adherence to these regulations.

Patient Satisfaction

Patients expect to receive clear and accurate billing statements and prompt attention to any questions or concerns they may have. Good AR management can encourage customer loyalty, repeat business, and positive word-of-mouth recommendations, in addition to ensuring patient happiness.

How Does Accounts Receivable Work?

Accounts receivable in medical billing works by tracking the money owed to a healthcare provider by patients or insurance companies for services rendered. The process of accounts receivable management typically involves the following steps:

• Patient billing
• Process insurance claims with close follow-up
• Tracking and monitoring accounts receivable. This can be done manually or through software.
• Managing claims denial and collections
• Maximizing accounts receivable by taking a proactive approach to bills, collections, and customer service

Common Challenges In Managing Accounts Receivable

Healthcare providers face several common challenges when managing accounts receivable in the medical billing process. Some of these challenges include:

Denied Claims

One of the biggest challenges in accounts receivable is dealing with denied claims. Insurance payers deny claims for various reasons, including errors in coding or billing, lack of pre-authorization, or incorrect patient information.

Aging Accounts

When payments are not received in a timely manner, accounts receivable can become "aged" or overdue. This can lead to financial strain on the healthcare provider and can also negatively impact their credit score.

Patient Responsibility

Determining the patient's responsibility for payment can be a difficult and complex process, mainly when dealing with insurance plans that offer multiple levels of coverage or have other restrictions in place. For example, some plans may require pre-authorization before services can be rendered or may only cover a portion of the cost. Additionally, insurers may also deny claims for services that are deemed necessary or non-essential.

Insurance Reimbursement

Insurance companies may reimburse healthcare providers at different rates, making it difficult to forecast revenue accurately and manage cash flow. This is because insurers often base their reimbursement on various factors, such as the provider's negotiated rate with the insurer, geographical location, individual services rendered, and more. As such, forecasting can be challenging and require a manual review of each claim.

Documentation

Maintaining accurate and complete documentation is critical to the accounts receivable process. However, keeping up with the large volume of documentation required for medical billing can be challenging.

Technology

Keeping up with the latest technology and software used in medical billing and accounts receivable can also be difficult for some healthcare providers. Often, these technologies are rapidly changing and updating, making it challenging to stay current. As such, healthcare providers must use specialized software designed to manage medical billing and accounts receivable complexities.

Best Practices For Managing Accounts Receivable

Managing accounts receivable is critical for any healthcare organization to ensure smooth cash flow, timely payment, and profitability. Here are some best practices for managing accounts receivable in the healthcare industry:

Accurate Billing And Coding

Accurate billing and coding are essential to successful accounts receivable management. Proper coding of services provided and accurate invoicing helps ensure timely payments from payers. It is important to stay up-to-date with coding conventions and changes in applicable codes, as well as the rules and regulations governing insurance reimbursement for medical care. Medical practices should also leverage any available software that can automate the billing process for added accuracy and efficiency.

Insurance Verification

Insurance verification is an essential step in the healthcare accounts receivable process. Ensuring that a patient's coverage is active before providing services eliminates potential hassles after completing treatment or procedures. It is also wise to confirm which services are covered by a patient's plan so that there are no unexpected out-of-pocket costs for the patient at the time of service. 

Patient Engagement

Engaging patients in their personal financial responsibility should be noticed when managing accounts receivable on behalf of medical practice. This can include clearly communicating payment policies, sending timely invoices, providing multiple payment options, offering discounts for early payment, arranging payment plans if needed, following up on overdue balances, and collecting co-payments at the time of service whenever possible. 

Technology

Technology solutions such as electronic health records (EHR) systems and cloud-based billing platforms can simplify accounts receivable tasks while improving accuracy and efficiency. Automation tools can streamline processes such as billing and follow-up workflow while providing better visibility into each stage of the process so that bottlenecks can be identified quicker, allowing for faster resolution times. 

Outsourcing

Outsourcing accounts receivable activities to an outside firm may be beneficial when faced with large volumes or complex collections requirements. Professional firms will typically have access to advanced technology tools as well as specific expertise related to Medicare/Medicaid reimbursement requirements, HIPAA compliance issues, legal remedies for delinquent payments, and other collection options. 

Training

Training staff regularly on best practices related to accounts receivable management will ensure that everyone involved in the process understands how it works and how their role contributes to its success or failure. This training should cover topics such as insurance policy updates, billing requirements, policies & procedures related to collections, etc. 

Monitoring And Reporting

Regular monitoring of key performance indicators (KPIs) associated with the accounts receivable process is necessary to identify areas that need improvement or additional resources allocated to meet goals, such as reducing aging days outstanding (ADO). Tracking metrics such as average days delinquent, charge capture rate (CCR), denial rate (DR), collection rate (CR), etc., will provide insights into where improvements should be made within the organization's revenue cycle management operations.

Enhanced Your Accounts Receivable In Medical Billing At Enter.Health

Enter.health is a cloud-based medical billing platform that helps healthcare providers streamline their accounts receivable processes. We offer automated payment reminders, integrated credit card processing, RCM solutions, and real-time reporting to help medical billers manage AR more efficiently. We also assist providers in reducing their accounts receivable workload, improving collections accuracy, and maximizing reimbursements for all payers. So consult us today and start using our advanced technology to enhance your healthcare business!