Determine Goals for A/R Days for the Facility
The ideal number of A/R days varies depending on the type of facility and its specific mix of payers. Typically single speciality facilities (such as an ear, nose, and throat center) can aim for a lower number of A/R days than a multi-speciality center. Defining a goal for A/R days is step one to achieving that goal.
Work Toward Timely, Accurate Documentation
By ensuring timely and accurate documentation for coding and billing cases and adequate revenue cycle staffing, A/R days can be reduced. Reviewing transcription turnaround times can find inefficiencies that can be corrected, and having consistent communication with doctors on outstanding dictation can ensure timely completion of this critical process.
Set “Clean Claim” Goals
Make sure your coders and billers (or billing company) understand your expectations for clean claims. Set a goal of getting clean claims out within 48 hours of receipt of the required documentation. Also make your goals for follow-up on electronic rejections on uploaded claims crystal clear.
Manage the Claims Denial Process Effectively
Meeting your goal for days in A/R is essential for keeping the healthcare revenue cycle on track. Ensure you have processes in place for tracking denials and that your personnel understand how denials are to be handled to minimize time to payment.
Bring in Specialized Outside Help When Necessary. Ensure these folks have years of billing and collection experience. Also consider bringing in a team lead to monitor performance of the project.
If your healthcare revenue cycle is prolonged to the point that it’s affecting cash flow, you may find that managing such an A/R emergency is difficult or unrealistic. An increasingly popular option is bringing in a dedicated, professional team of patient financial services experts to work at your facility, using your systems, to bring A/R days down and increase cash flow. Do not worry too much about travel, lodging and other associated expenses. You are paying for expertise.
Conclusion
Keeping up with the ever-changing requirements of third-party payers makes shortening the healthcare revenue cycle challenging, particularly as more people are becoming insured. Assuming that you’ll be able to handle these challenges is risky. The best time to bring in outside revenue cycle experts is before cash flow and A/R days are affected. Some revenue cycle firms specialize in offering interim revenue cycle staffing to healthcare providers.
