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Is your practice victim to a high volume of pending AR? Is cash flow becoming an increasingly worrisome issue? Read with us as we examine what generally goes wrong when it comes to AR in a healthcare practice. There are numerous reasons and if you’re nodding to even one of these, you have to seriously consider redefining a few business processes and changing the way your practice functions in the billing area.
A very concerning issue that plagues physicians and threatens a successful practice, is insurances declining reimbursements for the services provided to patients. This is an alarming trend. Though doctors put in their best efforts in ethically providing quality care to their patients, insurance agencies tend to deny payments due to a variety of reasons.
5 reasons for delayed Account Receivables
1.The first major reason is downcoding by physicians This may seem surprising, but it is done to avoid Medicare audits. If Medicare suspects you are overcoding, it will raise a red flag and this will result in an audit and subsequent penalization if found guilty. So to avoid this, doctors tend to downcode when in doubt, or if they encounter gray areas in coding. Needless to say, this results in revenue loss for medical practitioners. Doctors do not have time to spend on coding research.
2.The second reason is that most doctors are not well-versed in medical codes. This is where a certified coder may be able to help you out. The coder understands the subtle nuances of any coding scenario and clearly explains them to the doctor and requests for sufficient documentation regarding all the procedures performed. When the adequate documentation is provided, payments from the payer usually follow soon.
3.The third reason is time. While providing optimal care to the patients, doctors go out of their way to ensure the patient is following instructions as directed and their focus is primarily on the patient’s health. Doctors do not prefer clerical work and avoid paperwork or EHR work. But if sufficient documentation does not accompany claims, this will result in lowered payment for the services provided.
4.Inept staff is also one of the reasons that doctors do not realize the funds that they deserve for the services offered. It is not easy to find certified coders who can smoothly ensure reduced denials. When clerical staff performs erroneous coding, it could worsen the situation rather than help! When a claim is denied, it goes into a vicious cycle which is difficult to overcome.
5.Most doctors do not realize that the overhead costs of an in-house team are slowly gnawing away at the already low cash-flow. Outsourcing is a sure shot way to keep the revenue cycle in great shape. They do not realize that outsourcing is actually inexpensive and a lot more reliable compared to an in-house billing team. Outsourcing brings to you AAPC certified coders at 40% costs! An outsourced revenue cycle management team is the best way to clear those pending denials and effectively reduce days in AR.
Having said that, Velan HCS would like to offer our services to enhance your cash-flow and reduce the AR to minimal. We would like doctors to pursue their primary duty of taking care of the health of the patient while we work in the background and run things smoothly on the coding and billing front. Our efforts are focused towards increasing cash-flow for your practice while being easy on your pockets.
Certified coders are in high demand currently due to the recent transition from ICD-9 to ICD-10 codes. Due to the baby boomer generation of medical coders retiring, a huge vacuum has been created which needs to be filled with new generation coders.
Velan HCS takes pride in informing you that we have AAPC certified coders on board who can take care of all your coding needs. Our RCM team works around the clock to provide highly efficient services that ensure customer delight. We specialize in laboratory billing services as well!