The Eight Areas of Medical Accounts Receivable Collection

When it comes to medical accounts receivable collection, the aim is to shorten the collection period as much as possible. The term patient accounts, or accounts receivables, describes the revenue a provider has generated but has not collected. In order to ensure adequate cash flow, it is vital for practices to maximize revenue potential. AR management involves almost all parts of the practice. Therefore, to successfully manage AR collections, it is important to understand how every department affects the practice’s revenue cycle.

  1. The Legal Concepts

This area involves the understanding and the following of federal and state regulations. It involves vigilance against fraud by both the practice’s employees and patients. Fraud is common in the healthcare sector. From billing for treatments never performed to upcoding charges for higher rates of reimbursement, it’s vital to recognize fraudulent practices.

  1. Negotiating Contracts

This involves forging financial relationships with managed care organizations. These represent as much as 50 percent of all the average medical office’s net revenue. Comprehensive knowledge is vital to properly negotiate managed care contracts. A practice should be aware of its market and should take legal advice when necessary.

  1. Compliance

Compliance is vital for all medical offices. Therefore, it is essential to have a policy for compliance. This should cover all internal auditing and monitoring and implementation of practice and compliance standards. It should also designate a specified compliance officer and outline how it will carry out proper education and training.

  1. Patient Rights

It is key to forge strong relationships between healthcare professionals and patients. They must also strengthen consumer confidence through a healthcare system that is responsive to their needs. Providers need to give patients the information they need to understand their healthcare issues and their financial implications. However, patients have responsibilities, too. Part of this involves meeting their financial obligations and paying their invoices in a timely manner.

  1. Patient Access

A practice’s success depends on the performance of its Patient Access service. This involves entering the demographic information for each patient on his or her initial presentation. With appropriate staffing levels, adequate training, and the right resources, teams can perform well. This ensures the right level of care for each patient.

  1. Charge Capturing

Charge capture is a key element in medical accounts receivable collection. We cannot underestimate its importance. All clinical staff members across each department need to be aware of their responsibilities in this respect. They must produce accurate documentation to capture the correct charges. It is essential to link the correct medical code to each service or procedure rendered to the patient. All clinical areas have a vital role to play in this.

  1. Management of Health Information

Management of health information involves the maintenance, storage, and retrieval of all patient healthcare information. It must adhere to all accrediting agencies’ state and federal requirements. The health information management framework includes medical coding, transcription, necessity, staff support, records assembly, maintenance, and retrieval. It also guarantees security and privacy for patients with regards to their personal data. Ensuring HIPAA compliance is a key element of this.

  1. Services for Patient Finances

Ultimately, the patient financial services department is responsible for the timely and accurate invoicing and collection of payments. It is vital to understand insurance payers, as well as the regulations and laws in place within the healthcare sector. Practice billers must submit claims on time to insurers. They must also ensure that they invoice patients correctly and put measures in place to collect on those invoices. It is paramount to have an effective follow-up process for both insurer and patient payments.

Another key element of patient financial services is making sure efficient payment methods are in place to facilitate collections. Managing patient payments with the most up-to-date payment processing solutions is the best answer to this. Tailored to the needs of the healthcare industry, BillingTree’s solutions are flexible and convenient. They offer essential versatility and allow patients to make payments online or by telephone using their preferred method of payment. Meanwhile, practices can benefit from electronic bill presentment and a streamlined payment process. This frees up staff time while the practice collects more revenue. Patients enjoy a more positive payment experience and feel more satisfied with the ease of settling their invoices. Healthcare practices enjoy the benefits of a constant stream of revenue to boost their cash flow.

Eight Areas in Collaboration

The cooperation and collaboration of all eight areas are vital for medical accounts receivable collection to be successful. While sometimes unexpected obstacles arise to affect AR collection periods, practice leaders can identify, then, adjust those barriers. As a result, a healthcare organization can become more successful. With effective collections strategies in place, practices can go from strength to strength. Never has this been more important than in today’s competitive modern healthcare industry when patient satisfaction is paramount.