3 Reasons a Medical Billing Company Can Recover Old AR Better than You Can! | XyberMed

The amount due from old AR accounts typically represents a significant portion of a medical company's potential revenue. The trick, however, is to turn that money from "potential" to "actual" revenue. The longer an invoice goes unpaid, the less likely it is to ever be paid, so efficient management of old accounts receivable is important.

The problem is that collecting old bills, whether from insurers or patients, is time-consuming. To be successful, a system is needed that is applied by well-trained staff who understand billing codes and how payers refer to billing receivables. 

Collection agencies that use old-school collection agency methods of calling and threatening people with bad credit reports are not successful with medical bills. You have to understand the bill and be able to explain insurance coverage and the patient's role in helping them make payment. But that also requires a lot of time that in-house staff may not have.

Separating the administrative process of billing from the medical practice by outsourcing it to a medical billing company has proven to be a successful solution for many medical businesses.

Why follow-up management is such an important part of the medical billing process

In addition to employees who can spend an entire workday processing outgoing invoices, there are several functional reasons why a medical billing company has more success in collections, both for patient bills and for reimbursement of denied claims. 

1. Medical Billing Companies Have More Resources.

Medical billing companies have more resources to recover old claims that have been denied by insurance companies. These resources include experienced billing staff, software programs that can track the status of claims and appeals, and relationships with insurance companies that allow them to get results quickly. 

In-house billers may not have access to all of these resources, which can result in a longer timeframe to recover claims. In addition, medical billing companies are experts in billing procedures and know how to submit claims correctly the first time, so they are less likely to be denied. This expertise can save your practice time and money in the long run.

Because of the costs involved, a medical billing company has access to more databases and software than in-house billing departments. Medical practices need to use their software for as long as possible because it is a large investment, but keeping the software current is part of being a good medical billing company on a regular basis.

2. Medical Billing Companies Have More Experience

Their own staff can only handle a certain number of claims at a time. A good medical billing company has the systems in place to process denied claims quickly and efficiently. 

They also have the resources to follow up on unpaid claims and revise denied or rejected claims. In this way, they can avoid time-barred claims with insurance companies and government payers that would otherwise be a large source of revenue. 

Insurers are more likely to work with a billing company than an in-house biller. This is because the billing company is seen as more impartial and less biased toward one party or the other. All of these factors combine to make working with a medical billing company a much better option for collecting old accounts receivable than working with an in-house biller.

Medical billing companies also have more experience dealing with many different insurance companies and payers. Their staff is experienced in dealing with the various systems and the specifics and requirements of each, which can result in a higher percentage of paid claims.

3. Medical Billing Companies Are More Accurate.

Medical billing companies have the advantage of having more experience and expertise when it comes to filing and following up on denied medical billing claims, so they make fewer mistakes. Their experience with denied claims gives them a better understanding of how to work with insurance companies and payers. 

Professional billers also know what to look for when a claim is denied and how to resolve it in any situation. Insurers change their requirements regularly, and keeping up with all the details requires ongoing education.

In addition to denials, rejected medical billing claims are not uncommon, usually due to minor errors such as misspellings or mismatched dates. Professional billers are familiar with all the little things that cause problems and have a system in place to quickly review claims for errors before submission.

By outsourcing to billing companies, medical professionals can focus on patients

Medical billing is a major headache for physicians who try to do it themselves. In fact, it's a major reason physicians take early retirement because it's so annoying and time-consuming that they feel they spend more time and energy on it than on patients.

They have a lot of responsibility and even liability, and the whole process takes too much time and attention. Medical billing companies have employees who deal exclusively with billing and have years of experience in this field, so the process is not a problem for them, but just normal work.

Whether you hire a collection agency for accounts receivable management or a full-service medical billing company to manage your old receivables, you will benefit from more revenue and less hassle. 

When hiring a collection agency to manage your old receivables, keep in mind that you can outsource just that task at first, and if things go well, you can choose to outsource all of your billing. By working with a company that handles all aspects of medical revenue cycle management (RCM), you have the opportunity to simplify the transition because your systems are already integrated. 

1. Review Of Prior Claims:

Most organizations have many unresolved, denied, and rejected claims. Even tiny details like a misspelled name or incorrect date can result in a claim being denied. When Medcare MSO begins working on your RCM, we will review all outstanding claims and find a resolution. Past clients have been amazed at the amount of additional revenue we have been able to generate for them because we have billers who are experienced in each specialty, who identify problems and correct errors.

Rejected and denied claims and the resulting delays in receiving payment place an unnecessary burden on medical staff, physicians, clinic and hospital administrators. This can lead to a vicious cycle where problems with claims cause stress for staff, so the problems are ignored, but the lost revenue causes a different kind of stress for the practice. Unresolved claims are no small matter.

The Medical Group Management Association (MGMA) has found that 50-65% of denied claims are not even attempted to be resolved. That translates into huge revenue losses.

2. Maintain billing and coding records:

XyberMed documents all claims, payments, denials, and claims resolution. We then examine the results to identify trends and determine how to avoid the problem in the future.

3. monthly review of invoices:

Rather than just sending a memo when an error is found, Medcare MSO holds monthly meetings attended by all staff involved with accounts receivable, including everyone working on rejection analysis, bill posting, documentation, CPT coding, and even data entry operators. By evaluating the service and providing ongoing training in this manner, we are able to maintain a high level of performance and quality of operations.

4. Dedicated AR teams for accounts receivable collection:

Keeping up with changes in medical billing codes, insurance plans, and government payer regulations requires a dedicated team that can focus on these things. In addition to the commonly used codes, each specialty has a subset of codes specific to their practice, and some of these can be very complicated. In many cases, such as surgical procedures, there are bundled charges, but when something is performed outside of the expected parts of the process, special coding is required.