Aged accounts receivable (AR) can be a significant challenge for healthcare providers, often indicating process breakdowns that require expertise and targeted strategies to resolve. As hospitals and healthcare systems strive to maintain financial stability, containing aged AR becomes paramount. Here are 10 effective strategies to help healthcare providers manage and reduce aging AR in their revenue cycle management (RCM) process:
1. Focus on Denial Avoidance
The key to containing aging AR is to prevent claims from falling into the 30+ day category in the first place. Work closely with your utilization review team, case management team, and physician advisors to avoid denials upfront. This includes ensuring proper authorization, verifying the appropriate level of care, and providing comprehensive documentation to support claims.
2. Improve Financial Clearance Rates
Implement an automated workflow solution and develop dashboards to capitalize on real-time reporting and operational opportunities. Focus on improving financial clearance rates by ensuring authorization, verification, and notification are completed by the date of service. This approach can significantly reduce denials related to authorization and eligibility issues.
3. Enhance Point-of-Service Collections
Increase efforts to collect patient payments at the point of service. Utilize charge estimator tools to provide patients with pre-service estimates, allowing them to understand their financial responsibility before receiving care. This approach can lead to improved collection rates and reduced AR days.
4. Implement Cross-Functional Collaboration
Create a cross-functional revenue cycle review team with key leaders from across the system. This team should monitor current trends, develop strategies to reduce backlogs, and discuss opportunities to refine processes. Regular meetings and daily/weekly reports can help track performance against goals and address issues promptly.
5. Prioritize Clean Claims
Focus on submitting clean claims to prevent denials-causing errors from the start. Implement a comprehensive registration process to gather accurate patient information, check eligibility, and verify in-network coverage prior to appointments. Ensure that the correct payer information is added to patient accounts and that services are properly authorized.
6. Maintain Accurate Data
Regularly update patient information, physician credentials, and contracts to prevent errors that can lead to denials. Ensure that all necessary medical notes are scanned into patient records and that required documents, such as sterilization forms, are properly signed and filed.
7. Develop Strategic Claims Prioritization
Create a balanced approach to working claims based on both age and potential yield. While it’s important to address older claims, don’t neglect high-value or complex claims from certain payers that may require more time and attention. Develop a strategy that gives equal attention to both old and new accounts while flagging difficult payers for earlier intervention.
8. Create Efficient Workflows
Implement work queues or workflows that identify and flag common denial types, such as maternal or infant claims. Use denials tracking data to inform the creation of these workflows, ensuring that problematic areas receive increased attention. This approach can help quickly identify and overturn denials, reducing AR days.
9. Leverage Automation and AI
Implement AI-powered automation to improve claim processing efficiency and cost-effectiveness. Advanced automation can help prioritize problematic accounts, work claim denials effectively, ensure timely and accurate resubmissions, and promptly respond to payer follow-up requests. This technology can significantly reduce the time spent on repetitive tasks and improve overall AR management.
10. Build Strategic Partnerships
Consider partnering with an experienced vendor like Aspirion to enhance your RCM capabilities. A specialized partner brings extensive expertise in handling complex claims, particularly in areas like Medicare and Medicaid billing. By leveraging our deep knowledge and advanced systems, you can significantly improve your bottom line and reduce errors in managing challenging accounts. Such partnerships can provide access to subject matter experts (SMEs) who offer valuable guidance and stay up-to-date with the latest regulatory changes. This approach not only streamlines your AR processes but also allows your internal team to focus on core operational tasks, ultimately leading to improved financial outcomes and reduced aged AR.
Additional Tips for Success:
- Conduct regular team meetings to discuss AR reports and collaborate on issue resolution
- Analyze denial patterns for individual payers to identify and address recurring problems
- Work on errors and denials as soon as they appear in work queues to prevent further delays
- Stay informed about changing payer requirements and adjust processes accordingly
- Prioritize the patient financial experience by discussing price estimates upfront and offering payment plans or financial assistance options when necessary
Containing aged AR requires a multifaceted approach that combines process improvements, strategic prioritization, and technological advancements. By implementing these strategies, healthcare providers can significantly reduce their days in AR, improve cash flow, and maintain a healthier revenue cycle.
Remember that success in managing aged AR is an ongoing process. Regularly review and adjust your strategies based on performance metrics and changing healthcare industry dynamics. With consistent effort and a commitment to improvement, healthcare organizations can achieve and maintain optimal AR management, ensuring financial stability and continued quality patient care.
Are you looking to see a dramatic reduction in your aged AR? Discover how our cutting-edge AI-powered RCM platform can transform your financial performance. Backed by a team of expert data scientists, legal professionals, and clinicians, we offer a comprehensive solution to streamline your revenue recovery process. Our innovative approach allows you to focus on what matters most—patient care—while we handle the complexities of maximizing your reimbursements. Experience rapid and efficient revenue enhancement without the burden of managing it yourself. Ready to elevate your financial outcomes? Contact us today!
Want to learn how Aspirion can help your hospital strengthen its revenue cycle? Let’s talk here!
