Billing: Become a billing warrior

A. Aggressive accounts receivable management is serious business and keeping your A/R clean requires setting a very high but attainable bar. Start with a standard of achieving less than 60-days collection, forcing your team to look at internal processes causing claims to exceed that. On average, clean claims are paid within the initial 30 days after the billed date; and secondary claims are paid within 30 to 60 days.

Achieving this standard requires establishing internal processes that support the team. To start, determine the average claim value making up 80% of your receivables. For example, you may assume 80% of your revenue is coming from equipment rentals that bill at $70 per month, but on closer examination you may find that the 80% comes for all supplies that bill at X. Once you identify where 80% of your revenue lies, focus your collections to monitor the progress of that target.

Claims in the 31 to 60 days bucket should be reviewed. Categorize your findings and create worklists for your collection teams to address. Also, re-tool any internal processes causing issues in each category. Fixing and rebilling the corrected claims will reset the claims in the 0 to 30 days bucket. Any claims with balances due to CO-45 adjustments (indicating billing above contracted amounts) should be written off. Finally, outsource your patient balances to a reputable healthcare receivables management company as they are better suited for managing these collections and will yield you a greater return, freeing your internal team to work on payer collections.

A/R over 120 days should be outsourced or written off depending on the circumstances. Contact the provider relations departments of problematic payers who are slow to pay to work out a bulk collection strategy.

Best of luck and remember to be proactive and aggressive.

Ted Jones is CEO of bflow Solutions. Reach him at ted@bflowsolutions.com.