Medical Billing: Taking Control Of Accounts Receivable

Managing and maintaining Accounts Receivable is not always uncomplicated, but it is one of the most important and necessary aspects of medical billing. Accounts Receivable (A/R), which fundamentally is referring to charges still awaiting payment for services rendered. It is essential that everyone on the medical billing team understand what A/R means for the practice. When A/R is neglected, revenue is not received in a timely way (if at all) for aging claims. On the other hand when it is maintained properly, A/R will generate the maximum amount of income for all employees in the practice.


The following are some important points for taking control of your A/R:

Begin by establishing an A/R process. Create a spreadsheet or other form of record keeping to document A/R on a regular (ie. weekly or monthly) basis. The spreadsheet should include days in A/R and balances remaining within those time frames. Accurate record keeping allows you to know what claims remain unpaid and how long they have been aging.

Another suggestion is to find ways to communicate A/R requirements with the medical billing team. Continuous reporting of A/R endeavors could include comments on each line item to document work completed, or work to be completed, and accommodate employee motivation along the way. This approach allows each account’s A/R to be reviewed and thereby determine the A/R percentage for each practice and then allow the comparison with the current month to previous months. This can help project a trajectory of A/R success. It will likely also help to motivate staff who will be able to see that their efforts are paying off. It can also indicate where improvement and attention should be directed.

For anyone who has worked in medical billing, it is common knowledge that some insurance companies pay slower than others. So, it is imperative to understand the payor processes. Sometimes billing staff may be unaware of certain processes and guidelines put forth by individual insurance companies. It is important for all staff members to learn the processes for most (if not all) insurance companies.

Naturally, payor processes will likely differ markedly depending on the state in which you are operating. At RevPro Healthcare Solutions, we are constantly navigating through the complicated healthcare field as we continue to learn about the guidelines and processes for specific payors. We have set guidelines for understanding when reimbursement should have been received and when to act on claims that are aging. We are confident in our ability to accelerate the reimbursement timeline for most payors as a result.

Finally, the importance of documentation and following up on appeals is a critical facet of maintaining patient collections. The appeals processes can differ significantly depending on which insurance company the appeal is regarding. Some companies and some states require specific forms. Others depend upon paper appeals. And still others utilize electronic appeals. While the appeals process can be daunting, follow up on appeals that have been submitted is crucial. At RevPro Healthcare Solutions, we follow-up on appeals in a timely manner to ensure receipt of the appeal as well as the status of an appeal. Let’s say for instance that, for whatever reason, an appeal has not been received by an insurance company. Documenting appeals and keeping copies of appeals will make follow-up and resubmissions easier.

Patient collections are another necessary aspect of A/R to consider. We highly recommend that every practice obtain a collection agency available. The collections process, however, should be maintained by your billing staff. Keeping accurate records of all patient accounts sent to collections is essential and should include which accounts are being held out of the collection process and why, as well as the status of collections paid. We recommend that all of this data be notated on a secure and shared document and on each patient account as well.

If you would like more information regarding any medical billing service, call 561-578-8400 at RevPro Healthcare Services, or use our contact form here (link). We can really help make a difference to your bottom line.

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