Account receivable management is critical to any practice’s revenue cycle. With insurance companies increasingly inventing and implementing new and more complex sets of rules for medical procedures, practices are experiencing more underpayments and denials than ever. As a result, doctors, pharmacists, and other practitioners are finding it particularly difficult to manage under ever-changing standards and regulations for practices and drugs. This is also causing many doctors to shift their focus away from private practices, especially with increasing challenges in sustainability. More and more doctors and practitioners are therefore looking for a better and more innovative ways to approach account receivable management and amplify their bottom line.
Claim submission management is one of the best ways to avoid and bypass high levels of rejections. Generally, a submitted claim that hasn’t been paid during the first cycle of submission is likely to cause payment delays or never get paid at all. Identifying claims that have high chances of being rejected with the help of a well designed and intelligent engine that adapts to constant changes and updates on payer rules and regulations can help you prioritize account receivables.
Another major challenge when it comes to account receivable management is underpayment. Every doctor, for instance has a unique contract with each unique payer. This means insurers may pay a different amount depending on the type of medical insurance each patient has, even when they went in for or has received the same treatment for the same medical condition. Proper payment tracking is therefore critical to ensure that contracts are fully paid all the time as well as to predict future collections.
Documentation and workflow management are also critical parts of account receivable management. Having the proper tools to ensure proper documentation and efficient workflow enhances management of accounts receivables and makes way for proper reporting and analysis, which further translates to practice efficiency and success.
