AR Follow-up at 855mybilly

Accounts Receivable (AR) Follow-up in medical billing is the process of managing and pursuing unpaid or partially paid claims to ensure that healthcare providers receive the full payment for services rendered. AR Follow-up is a critical component of revenue cycle management, as it directly impacts the financial health of a healthcare practice.

Key Activities in AR Follow-up

Identifying Unpaid Claims:

• The first step in AR follow-up is identifying claims that have not been paid within the expected time frame. This involves regularly reviewing the accounts receivable aging report, which categorizes unpaid claims by the length of time they have been outstanding (e.g., 30 days, 60 days, 90 days, etc.).

Analyzing the Reason for Non-Payment:

• Once unpaid claims are identified, the next step is to determine why they haven’t been paid. Common reasons include claim denials, rejections, delays in processing by the payer, or issues with the patient’s insurance coverage.

Correcting and Resubmitting Claims:

• If a claim was rejected or denied due to errors, the billing team will correct the errors and resubmit the claim. This might involve updating coding, providing additional documentation, or addressing issues related to patient information.

Contacting Insurance Companies:

• AR follow-up often involves contacting insurance companies to inquire about the status of outstanding claims, request payment, or resolve issues that are delaying payment. This may require multiple follow-ups and detailed documentation of each interaction.

Appealing Denied Claims:

• If a claim has been denied, the AR follow-up team may need to file an appeal with the insurance company. This involves providing additional information, medical records, or clarifying why the services provided were medically necessary.

Patient Billing and Follow-up:

• If the insurance company has paid its portion, and there is a remaining balance, the billing team may need to follow up with the patient for payment. This includes sending statements, making phone calls, and setting up payment plans if necessary.

Monitoring and Reporting:

• Regular monitoring of AR and generating reports help track the effectiveness of follow-up activities. Key performance indicators (KPIs) such as the AR aging report, days in AR, and the percentage of claims paid on the first submission are often used to assess performance.

In summary, AR Follow-up in medical billing is about ensuring that healthcare providers receive timely and accurate payments for the services they provide, minimizing delays, denials, and lost revenue.