Factors Impacting Medical Accounts Receivable Services and How to Fix Them

Suboptimal medical accounts receivable services is the biggest enemy of a decent revenue flow for hospitals. It is an integral part of the hospital revenue cycle management. This ensures that all the bills and payments owed by patients are duly processed and received.

A majority of medical enterprises are struggling with issues in their A/R services. This is causing them to let go of a major part of their revenue. On this note, we will explore the four key problems in medical accounts receivable services and learn how to fix them.

Rampant Claim Denials

Factors ranging from entering incorrect diagnostic medical code to not adhering to various insurers’ unique guidelines result in claim denials. This is considered as the chief reason behind AR services problems. The inability of professionals to follow up on those denied claims compounds the issue.

Resolution

Hospitals must dedicate professionals who can keep a strict eye on every claim before those are submitted. They must review every denied claim, make the necessary adjustments, and re-submit within the time stipulated by various insurance carriers.

Recurring Bad Debt

A surprise fee in medical bills is the biggest turn-off for patients. Most of them outrightly refuse to pay them. This results in medical caregivers stare at recurrence of bad debt. 

Resolution

Professionals must verify patients’ insurance coverage and then estimate the out-of-pocket expenses to be borne by patients. Post the estimation, patients must be let known of their patients’ responsibilities prior to rendering medical services to them. 

This eliminates the chances of surprise fees and ultimately reduces the recollection of bad debts.

Unwanted Write-Offs

There are several instances when patients deny paying the full amount right at the time of getting the medical care or after the service is done. This does not mean that patients deny paying their due at all. Most of them try to work out ways to make the payments in installments. 

But such cases require a consistent and proactive follow-up which most of the AR management teams fail to do. This ultimately results in an unnecessary writing off of patient dues.

Resolution

The resolution process must begin with fixing the average write-off benchmark. This will prevent random patient dues write offs.

Each write offs should go through managerial approval. The medical accounts receivable services team must track each write offs to understand the shortcoming in their reimbursement policies.

Limited Payment Mode

Limited mode to make payments seriously hinders patients’ ability to pay their dues right at the moment before they get the treatment. This prolongs the debt that can ultimately turn into a default.

Resolution

Patients should have the flexibility to pay their dues via different digital payment modes. This is particularly relevant for those who have worked on ways with their healthcare providers to pay their dues in installments.

Conclusion

AR management is a complicated task and cannot be fulfilled by professionals whose core competency lies elsewhere. It is another major reason that derail medical accounts receivable services. This is why medical firms must rely on third-party vendors who have professionals with years of expertise in the AR management domain. They know the intricacies and challenges associated with this process. Such a knowledge puts them at the best place to overcome all potential challenges and seamlessly execute these services to maximize hospitals’ revenue.

Related Articles

Latest Articles