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The number of services physicians, hospitals, and clinics are continuously increasing. Every time patients receive treatment, they owe a certain billable amount to the treatment centers or physicians. Thus giving rise to medical billing follow-up. Effective medical billing services or the subsequent insurance model assists medical practices in recovering the overdue payments from the insurance company, and that too on time.

Medical Billing Follow-Up

Ensuring timely and easier payments to providers is when the A/R (accounts receivable) follow-ups come into action. A/R follow-up helps healthcare providers run their practices smoothly and successfully. All of this, in addition to ensuring the owed amount gets refunded as soon as possible.
It helps healthcare service providers run their practice smoothly and successfully while refunding the owed amount as quickly as possible.

Three Stages of Medical Billing Follow-Up

Most billing specialists systematically perform the A/R follow-up. It usually spans three stages, including the following:

  • Initial Evaluation
  • Analysis and Prioritizing
  • Collection

Initial Evaluation

It involves the identification and analysis of claims that are listed on an A/R aging report. The A/R teams review the provider’s policies and classify claims that need adjustments.

Analysis and Prioritizing

The analysis and prioritizing phase is initiated once all the claims are classified and marked uncollectible. Furthermore, such claims where the carrier has not paid according to the contractual rates predefined with the healthcare provider.

Collections

The final stage of medical billing follow-up is collection. The identified claims within the filing limit of the carriers are re-filed after verification of important billing information. These verifications include the claims processing address and confirmation of other relevant healthcare billing rules. After posting payment details for pending/outstanding claims, the patient bills are produced as per client guidelines, and then these claims are followed up.

Top Reasons Why Medical Billing Follow-Up is Important

Most provider companies’ most significant challenge is healthcare billing follow-up or A/R management.

But why is A/R important? Below are some of the common/popular reasons, including:

1. Economic Stability of the Medical Practice

Any healthcare practice’s economic or financial stability depends massively on maintaining a continuous and positive cash flow. Healthcare practices must work to maintain a steady flow of revenue to cover expenses.

2. Recover Overdue Payments

The following reason for the importance of billing follow-up is that it helps everyone. The list includes recovery of overdue payments – all without a hassle. When a dedicated team continuously partakes in claims follow-up processes, it gets rather easy for provider practices to get payment on time.

3. Minimizing Time for Outstanding Accounts

The major goal and objective of medical billing follow-up is A/R management and reducing the time most accounts can remain outstanding. The follow-up teams track the accounts that still need to be paid, formulate a suitable action plan for securing payments, and further implement procedures for secure payments in the future.

4. No Missing Claims

One of the most significant reasons for payment delays is the claims not being received. It usually happens when the paper claims are misplaced. To avoid this, it is recommended to use electronic forms.

5.Denied Claims can be Followed Up

Depending on the denial reasons, you can send a new claims request with the needed corrections. Besides calling on insurance companies and finding out the reasons for denial as opposed to waiting for denial reasons via mail is essential. The follow-up from the A/R department ensures that all claims are followed until the very end.

5.Recover Pending Claims Owing to Lack of Information

In some instances, the claims remain pending for a specific time as more information is required from the member. First, a proper follow-up from the A/R team dutifully informs the members about the situation at hand, and appropriate action can then be put in place to speed up the process.

Final Words

Do you need assistance with A/R follow-up?
Even though A/R follow-up is essential to healthcare billing, most providers can only leverage its true power partially, as they lack the necessary skills.
Medical billing follow-up requires experienced and skillful workforce who can handle specialty-wise billing operations. Your billing follow-up team must also be experienced in dealing with specific insurance providers. If hiring and onboarding a skillful A/R expert is not possible, your practice can always outsource billing operations to a third-party billing company.

Frequently Asked Questions

The A/R team in a medical billing organization is responsible for taking care of the denied claims and even reopening those to receive maximum reimbursements from insurance companies.

Accuracy is the key facet of a medical billing process. Accuracy in billing is vital for ensuring that the customers are adequately charged. Furthermore, the accuracy of medical billing services also calls on correctly recording all transactions.

The A/R billing follow-up process is solely responsible for handling rejected/denied claims. Equally important is that your A/R team is also accountable for refiling such claims. 

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