Account Receivable Follow-Up Services

Managing **Accounts Receivable (A/R)** is crucial for physician offices to maintain a healthy revenue stream. Our **A/R Follow-Up** service is meticulously designed to streamline the claims follow-up process, increase revenue collection, and reduce the number of unpaid claims, ultimately boosting the financial performance of your practice. With years of experience in medical billing and collections, we offer timely and efficient follow-up on both **electronic** and **paper claims**, ensuring that claims are processed and paid without unnecessary delays.

Detailed A/R Follow-Up Process:

Our process starts after the physician's billing team submits **health insurance claims**—either **electronically**, via **paper HCFA forms**, or through **manual submission**. Based on the type of submission, our follow-up begins:

• Electronic Claims: Follow-up starts after 10+ days from submission, ensuring that claims are processed and checked in a timely manner.
• Paper or HCFA Claims: For manual claims, follow-up begins between 20 to 45 days after submission, depending on the complexity of the case and response from the payer.

Our team is proactive in tracking every claim to reduce payment delays and ensure higher collection rates. By automating parts of the process and employing manual methods for complex cases, we optimize the entire receivable cycle for healthcare providers.

Two Types of Claims Follow-Up:

We focus on two specific types of claims follow-up to ensure that no outstanding balance goes unnoticed:

• No Remark Claims: These are claims where absolutely no status is known, and we initiate contact to obtain an update and resolve any pending issues quickly.
• Last Remark Claims: These are claims that have received feedback but remain unpaid due to various reasons. We perform routine follow-up on these claims every month until resolution is achieved.

Common Reasons for Claim Rejections:

Claim rejections can arise for several reasons, often requiring careful review and follow-up to ensure a quick resolution. Some of the most common reasons include:

• Authorization issues
• Referral issues
• Medical necessity reviews and medical records requests
• Non-participation in the insurance network
• Terminated insurance coverage
• Coordination of benefits issues
• Incorrect diagnosis codes
• Inclusive procedures not being separated properly
• Partial payments or discrepancies in the allowed amount
• Out-of-network claim status and deductibles
• EDI (Electronic Data Interchange) rejections
• Letter of Protection (LOP) from attorney cases
• No status or "No claim on file" errors
• Worker’s Compensation and PIP (Personal Injury Protection) cases

Each of these reasons can delay or prevent payment, but with our dedicated follow-up service, we work diligently to resolve each issue quickly, ensuring you receive payment for the services rendered.

Our Three-Pronged Follow-Up Approach:

To efficiently resolve claims and reduce the accounts receivable backlog, we employ a **three-pronged follow-up approach** that includes:

• 1. Online Claims Follow-Up: We utilize insurance company websites and payer portals to check the status of outstanding claims and obtain real-time updates on unpaid balances.
• 2. Automated Claims Follow-Up (IVR): We call insurance companies directly, using their Interactive Voice Response (IVR) system to get claim status updates and identify issues with unpaid claims.
• 3. Insurance Company Representative Follow-Up: In cases where the online or automated systems fail to provide enough information, we contact live representatives from the insurance companies to get a more detailed explanation of claim denials or delays.

This layered approach ensures that every claim receives the attention it deserves, with multiple follow-up methods used to prevent delays and improve the chances of successful collection.

Key Benefits of Our A/R Follow-Up Service:

By using our **A/R Follow-Up service**, physician offices can experience several key benefits:

• Increased Revenue Collection: We help ensure that no claim goes unpaid, increasing your overall revenue and minimizing outstanding balances.
• Faster Payments: By starting follow-up promptly, we help reduce payment delays and get claims processed faster.
• Reduced Administrative Burden: We take on the responsibility of managing claims follow-up, allowing your staff to focus on patient care and other critical tasks.
• Improved Financial Health: By resolving claims quickly and efficiently, we help maintain a healthy cash flow for your practice.
• Expertise in Handling Complex Cases: Our team has extensive experience in handling difficult cases, such as out-of-network claims, worker’s compensation, and PIP claims.

Don't let unpaid claims hurt your practice's financial health. Partner with us to streamline your revenue cycle and ensure that you receive payment for every service rendered. Contact us today to learn how our A/R Follow-Up services can enhance your revenue collection process and support the growth of your practice.