We help healthcare providers reduce days in A/R with our timely follow-up Services that ensure you clearly understand the reasons for delays in accounts receivable and promptly follow-up with insurance companies and patients.
RM Healthcare deploys a team of seasoned accounts receivable follow-up specialists who work on the following areas:
Follow-up with insurance companies — We work on multiple contact channels with insurance companies – Website, fax, IVR, and Phone to get an accurate understanding of the claims' status. We also work with the end provider clients to improve the adoption of Websites as a channel of contact.
Develop policies and procedures for A/R follow-up — We monitor the aging bucket of the A/R and understand the dates by which the payers would have the information on the file. We initiate follow-up calls on the right number of days post submission of the claims, not to waste effort following with the payers before the date.
Automation — We have created practical tools to login into the payer website, generate queries, and fetch information on the claim's status.
Effective action plan — Our work does not end with merely obtaining the status of the claims. We go one step further and initiate the actions such as refiling of these claims and appeals to receive reimbursements, and perform analytics with a focus on reducing the days in A/R
Hospitals, physicians, and medical practices often get into messy situations with old A/R, including lack of staff to follow-up, ineffective write-off policies, ineffective closures, etc., leading to piled up volumes of insurance claims running into millions of dollars in aged A/R. We take on A/R backlog clearance as one-time projects with a very robust process that includes:
Assessment — We perform a claim quality analysis by grouping the claims on variables such as aging, payer group, and timely filing issues, and by different types of payers. This analysis helps us understand the quality of A/R, collectible A/R through a final clearance effort, and post-clearance valuation of the A/R before handing it over to collections agencies.
Develop Guidelines — Often, the very reason for messy A/R situations is a lack of clear policies on write-offs and negotiations with insurance companies due to the changes in leadership at the healthcare provider’s office, lack of laid down procedures and policies. When we take on an A/R backlog clearance project, we enable the healthcare provider and our billing company customers to set collection goals, define the negotiation process, and number the attempts required before we call a claim as noncollectable.
Retrieving Associated Clinical documentation — Often, A/R backlog clearance projects are on account of changes in the underlying system. Unless a process for effectively recovering clinical documentation exists, the collection process may be ineffective as the associated clinical documentation is not available.
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%.