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Common Practice Challenges: Keeping Those A/R Days In Check

Every business office manager knows the challenge of trying to hold down the number of days in accounts receivable (A/R) and I’m no exception. As business office manager at Orthopaedic Specialists of the Carolinas, I’m charged with managing a claim volume of roughly 500-600 patients per day for 22 physicians, 10 physician assistants and 13 therapists.

I take pride in the fact that even with such a large claim volume—and four different locations—we average about 30 days in A/R. We’ve managed to accomplish this through a few distinct efforts.

First, we have become more proactive about collecting patient-pay balances prior to surgeries and other high-dollar services. With the difficult economic times, many patients have either lost their insurance or opted to increase their deductibles—which obviously has a direct impact on A/R.

Eligibility solutions can help not only with the business side of operations, but also with patient care. Rather than simply billing patients for an amount they may or may not be prepared to pay, I want to give them as much autonomy as I can in their healthcare decisions. So, for any high-dollar service we offer, we use an eligibility solution to check benefits and tell patients upfront how much a procedure will cost out of pocket.

It’s a win-win situation: Patients benefit from the ability to make fully informed decisions about whether to proceed with recommended care; and we benefit from the ability to request payment prior to service. We can sit down with patients to construct payment plans that meet their needs—and increase our overall rate of payment.

On the insurance side, we also make sure we’re sending clean claims out the door quickly. I’m certainly not the first business manager to recognize the importance of solid editing tools. But we definitely speed turnaround through the ability to see claims errors online, and then fix them online without having to resubmit from our practice management system.

Electronic payment posting is yet another factor in our overall A/R success. It is a function perhaps not typically associated directly with A/R, yet a “receivable” is still just that until the money is deposited. Electronic posting has been so beneficial for our payment posters, now that they don’t have to touch every single patient claim. Their efficiency is such that we need fewer than two full-time equivalents (FTEs) to post our entire volume.

Holding down A/R days results from efforts made throughout the revenue cycle. It starts with arming both the practice and patients with information necessary to work together toward payment and care. It continues with tools that increase the efficiency of claims submission. And, finally, it ends with solutions that ensure we are accurately depositing every dollar our providers work so hard to earn.

What solutions do you have for keeping your practice’s A/R days in check? Share your experiences below.