Improving The Management of Your Accounts

One of the most frequent requests I get from physicians who are not my current clients is to visit on a quarterly basis to review their accounts receivable. The problem is that they only see what receipts come in. They really don’t know what t the staff is doing on a monthly basis to analyze these numbers. I am always amazed when I am presented with a report called accounts receivable aging which is a multi-page report listing the name of each patient and the balance within categories of current, 30-60, 60-90, 90-120 and over 120. The back page shows the totals of each category and a grand total. 

Okay I say- now what are you going to do with this report? The dedicated staff person might start to go through this report one patient at a time and start to dissect each category to figure out what is due from insurance and what is due from patient. This could take your billing person the entire month and after a while one account looks like the next which leads to a very inefficient process and an overwhelmed staff person.

So what is the alternative? Although knowing what your gross accounts receivable balance is important to you because you would like to try to figure on what money might be expected, this is not a report to use to bring more money into the practice. Instead, every good billing software program should be able to produce what i term your “outstanding claims” and your “guarantor balances”.

A review of outstanding claims every month (and i mean every month) will yield results before claims get too old and the insurance company issues that dreaded code: ‘timely filing denial’. A sharp billing person should not look at this report as foreign because many of the claims on this report have probably already resulted in a denial/problem which your staff should be working on. That is what leads to hopefully a pending file that is reviewed every month. Your staff does not have to look at outstanding claims that were transmitted in the previous 30-45 days as you must give claims a chance to be processed, but surely if you look at the report from 45 days ago and prior, every month, you will get a much better handle on your accounts receivable and your staff will have a tool to review claims that should have paid. Sometimes just resubmitting claims works because the claim did not reach the insurance company. That again speaks to the issue of timely filing, which is why i can’t say enough about making your outstanding claims report your friend.

On the other side of A/R management of course is patient balance bills. If there is a balance on the guarantor report, there should be a patient bill produced each month to match each line item. I urge your staff to know what they are sending to the patient; if the billing person cannot explain the reason for a balance bill, don’t expect to be paid. So the word clean applies here too (see article “cleaning up your claims for better results”) the cleaner the patient bill, the more notes in the computer to remind the staff of why there is a balance (deductible/co-pay/cost share/ not covered/ termed insurance, and the list goes on), the more chance a patient will at least make a payment plan if not just pay the whole balance at once. When I send out 100 balance bills from one of my billing clients, I expect 100 calls and i take the time to know what is in each balance. And when a patient calls to discuss the bill i make notes about any commitments and comments with date and time noted.

Fran Glucroft
Medical Office Manager
Fairfield, CT