ACCOUNTS RECEIVABLE

Accounts Receivable



Why Choose Rely On Us?
 

  • Having understood the physician pain, Rely On Us as a Revenue Cycle Management (RCM)   company primarily focuses on improving the physician cash flow, reduce rejections and follow   up with insurance / patients for prompt payments.

  • Our proven RCM strategies enhances revenue optimization and elevates the practice operational performance; more importantly help physician groups to address their day to day medical billing challenges and other revenue cycle management requirements.

  • As soon as we are on board, we quickly identify global issues and other process gaps to improve the Physicians cash flow / first pass rate & reduce rejections

  • Predominantly Rely On Us uses KPI metrics as a managing and checking point to improve the Net Collection Ratio of the Physician practice

  • Best RCM techniques are deployed to address delinquent accounts to completion especially the old or aged AR

  • Periodical reviews and management of bad debt accounts results in collection of payments.

 

Physician groups are always under tremendous stress to improve the quality of patient care and to reduce the healthcare cost.

Our Path To Success 
 

  • Charges are entered and submitted within a TAT of 48 hours from the DOS

  • Clearing house rejections are worked to resolution within a TAT of 24 hours

  • Prior to the claim submission, Eligibility verification will be performed to avoid eligibility denials

  • Aggressive follow up on aged AR claims.

  • For each specialty, MGMA standards are used for guidance and followed upon

  • Three levels of quality checks are implemented to ensure that set quality target percentage is achieved

  • Refresher training sessions to all the staff on Insurance information’s and updates.

  • Weekly, Monthly & Quarterly dashboards on the agreed KPI’s are published

  • Reconciliation Dashboard - Services Performed Vs Charges Entered Vs Charges Submitted to the insurance Vs Charges Accepted by the insurance

  • Submission of a clean claim to the payer is always the priority

 

Accounts Receivable Follow-Up Services 

 

Rely On Us works on AR by Age Trail Balance (ATB) by Insurance wise, thereby assisting physicians in obtaining faster payments, and lesser AR days

Primary goal of Rely On Us is to ensure that Insurance AR days is always lesser than 40 days.
 

Please refer the below AR work Flow

  • AR is analyzed based on the ATB reports and appropriate work-files are created based on Rejection codes, Dollar threshold, Payer wise, Service Date Wise, No Activity vs Rejection, Provider, Location etc., and allotted to the team members.

  • AR Work files will be worked to completion.

  • Status of the claim will be assigned to each account in the work file post working. In addition to the status, an action code will be assigned indicating the action taken on the claim

  • At the end of every week, detailed report will be run to identify the trends and gaps along with the status of the physician account

  • In short, AR Team works the account to completion in the following 3 ways namely: -

    • .Appealing or resubmission of claims for payments

    • Flipping the balance to the patient level based on the AR scenario

    • Adjusting the claims

  • Historical rejection data is compiled and used during refresher training program

RELY ON US Offers The Following Different Types Of Accounts Receivable Scope Of Work

Self-Pay A / R – Key Methodologies
 

  • Collection methodologies do vary by client depending on their policies and procedures

  • All accounts receive a series of phone calls and letters in addition to their statement series (Typically, each patient will receive two phone attempts and three letter attempts)

  • Delinquent accounts are identified and moved to collections.

  • Prioritization of accounts into various work queues

  • The account queues are sorted by balances, so special emphasis is always accorded to the higher patient balance accounts.

  • Our systematic approach ensures that all avenues of reimbursement from government eligibility program such as Medicaid, Charity Care and/or Financial Hardship are assessed and explored.

Remarkable Features Of A/R Follow-Up Services
 

  • Lesser A/R Days

  • Faster insurance payments

  • Increase in First Pass Ratio

  • Increase in NCR

  • Underpayment Follow Up

  • Skip Tracing on high $ patient accounts

  • Reduced eligibility rejections

  • Denial Management & Aged AR follow up

  • Appeals and resubmission of claims wherever it is appropriate

  • Business Intelligence Reporting

Key Metrics And Objectives 

Denial Management

  • Assist to ensure an overall Denial Rate (% of Gross Revenue) <= 7%

  • Underpayments additional collection rate >= 75%

  • Appealed denials overturned rate 40-60%

 

A/R Management

  • Percentage of Insurance A/R above 120 days at 12-18%

  • Assist to ensure Insurance A/R Days maintained at 35-45

  • Insurance Net Collection rate retained at 94-97%

 

 

Sample Reporting Template 

  • KPI: “Key Performance Indicators” helps us to review the performance of the process through various measures/metrics

  • Measures: Charges, Payments, Contractual Adjustments, Write Offs.

  • Metrics: AR Days, GCR, NCR, Self-Pay AR (%)

REQUEST FOR A  FREE QUOTE

USA OFFICE
1201 N Orange Street, Suite #7297

Wilmington, Delaware – 19801 1186
+1 800 62 555 72

INDIA OFFICE
1-11-251/11/1, Motilal Nehru Nagar, Begumpet
Behind PACE Hospital, Hyderabad, Telangana – 500016

RELY ON US HEALTHCARE SERVICES

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