10 Tips to Reduce A/R

10 Tips to Reduce A/R

1 Clean Claims: Make sure all claims go out the door clean. Mistakes will bounce back. Also, keep up with differing form requirements. Different carriers in different states require different information in different boxes on forms.

2 Speak Up: Doctor dictation must be timely and thorough to enable proper coding and billing. If the doctors are not specific enough in their descriptions, lost revenue will inevitably occur.

3 Timely Filing: Know your payer deadlines. In most states, a carrier has a certain time frame in which to pay. Be aware of those prompt payment rules and enforce them. Also be aware of any time constraints for filing claims in your contract. Processing can be lengthy, especially when things are flagged and returned. Be knowledgeable and make sure you allow plenty of time.

4 Two Weeks is Long Enough: Collections should start within two weeks after filing with any kind of a managed care organization. Medicare reimbursement by electronic funds transfer can be received within two weeks and many other managed care companies are switching to this payment process as well.

5 Payment Posting: Always post payments to patient accounts within 24 hours of receipt. Get it in the bank. The deposit is not earning interest if it’s sitting on your desk.

6 Know Your Contracts: It is important to know what is covered and what isn’t so everything eligible is paid and paid to the fullest extent.

7 Denial Logs: Develop a denial log. It’s a good way to identify and track denial trends. Internal errors may become evident, as well as unusual payor delays.

8 Be Persistent: Continually follow-up. If you receive a denial, resubmit. Stay on top of it.

9 Pile ’Em Up: Gather all claims by payor and do all of the claims that require a phone call to the company at one time. Due to long hold times, this will pay off in both time and economical terms.

10 Frequent Review: You should be touching every account within 30-days. Activity should be persistent.

Judie English is vice president of business operations of Surgery Center Billing, LLC and its sister company, Surgery Consultants of America. For more information, visit www.ascbilling.com. 

Recipe for Success:
Organization and Oversight

The first and essential step to organizing a successful surgery center venture is exactly that — organizing. Often the parties in a startup approach this critical beginning by simply implementing: choosing a name, filing to become an entity, and having an agreement drafted on rights and responsibilities of ownership.

These are part of organization, but the key additional challenge is determining how diverse individuals, trained, accustomed to, and highly competent in, independent decision-making and action will function together as a group.

Having a blueprint for true governance often distinguishes centers that grow and evolve proactively rather than reacting to issues.

Whether the surgery center is to be entirely physician owned or a hospital/physician joint venture, a knowledgeable management company can be an indispensable outside resource for perspective on these and other issues. Armed with baseline information, the group not only can select the most appropriate legal forms of operation, but can forge consensus on near-term and longer solutions.

Even if the management company is not involved in turnkey operations, it can offer an objective view as a non-voting Board advisor and facilitator. In that capacity, the management group can help shape and evolve a governance structure that contributes to quality, patient and staff satisfaction, and optimal return on investment.