An important process in RCM where majority of the only US based medical billing companies face challenge with overseas companies is effective A/R follow up management. Our A/R follow up staff understand the importance of effective follow up. As a company, we develop the skill set of the follow-up staff to take each encounter to the next step of resolution to get it paid.

Below three tabs contain Accounts Receivable Model

 

    • First Level
    • Mid Level
    • Last Level
Lead Analysis Team
  • There will be a Lead Analyst to drive the team
  • Lead Analyst will have one or more A/R Analysts
  • Lead Analyst will be responsible for finding and reporting trends
  • Each Analyst will be responsible for reviewing the encounter/patient account as a whole and provide brief history of the account for the A/R caller to place a phone call
  • Analyst will also perform any actions to resolve the account that does not require a phone call
  • These are the experienced staff with very good RCM A/R knowledge those who are groomed from the internal talent
  • With the Analyst/AR model below can happen,
    • a) Unnecessary payer phone calls will be reduced
    • b) Chances of an account/encounter getting paid during the 1st or 2nd touch is very high resulting in fast cash, reducing A/R days, 120+ aging, and reducing a lot of manual intervention.

AR Caller
  • There will be follow up Team Lead to drive the team
  • Team Lead will have one or more follow up staff
  • Team Lead will be responsible to ensure productivity requirement is met for the team
  • Each follow up staff will have work orders from their Analyst which would reduce the A/R caller analysis time and increase productivity
  • With this A/R Follow up/ Analyst model, chances of incorrect or inappropriate follow up will be very minimal
  • Possibility in addressing a good chunk of A/R in a month is very high

Quality Analyst
  • There will be Quality Team Lead to drive the team
  • QA Lead will have one or more Quality Analyst
  • Team lead will be responsible in sharing the error trends
  • Team lead will be doing the Pareto Analysis and CAPA will be shared for further training activity
  • Each Quality Analyst will ensure the encounter or the account was reviewed (A/R Analyst work) and addressed (A/R Caller) to take the account to the next step of resolution
  • Any encounter of account that does not meet the above said statement will be addressed again