Every practice wants to receive payment for claims in a timely manner. When payment moves past the 30 day mark, it can represent a cash flow issue at the very least—and potentially lost revenue in the worst case.
When I took over as practice administrator at Arkansas Allergy and Asthma Clinic three years ago, I inherited a lot of backlogged claims. With two dedicated billing staff to handle more than 60,000 claims each year, we all had to make a commitment to whittle away at our aging accounts receivable (A/R).
Using our clearinghouse, we began by sorting all our claims by date and rejection or denial type. In addition, the tools our clearinghouse provides allow us to categorize rejections and denials to help determine the root cause of the issues. With these tools, I was able to examine claims and determine what categories the mistakes were falling into. Most of the time, the problems causing a payment delay were fairly simple to fix and we started to be able to identify and respond proactively to more global concerns. For example, we had a lot of eligibility rejections and denials that we quickly addressed with additional front desk training.
We now regularly analyze claims in different time frames and categories—under 30 days, 30 to 60 days, and over 60 days, for example—to improve the timeliness of claims payment and reduce the number of aging claims. This not only helps us see which claims are taking longer to get paid, but also helps reveal the underlying reasons behind any delays.
Our practice continues to take this targeted approach, and the effort has paid off. In a recent report to our board of directors, I was elated to share that less than ten percent of our outstanding claims are more than 30 days old. Beyond that, we’ve increased productivity by identifying areas where staff struggle and providing training. This has not only increased employees’ knowledge, but also improved their accuracy when creating claims—which ultimately results in a smoother reimbursement process.
I can testify to the age-old adage, “Knowledge is power.” We’re now able to submit thousands of claims each week with a fairly low rejection rate because of the ability to identify where problems are, provide training, and support staff as they strive to improve the overall financial performance of our practice.