Global Healthcare Resource

Accounts
Receivable

Recover denied and unpaid claims with effective follow-up.

Accounts Receivable Follow-Up and Denial Management Services

Accelerate claim recovery and strengthen your cash flow. 


The numbers are striking. Payers deny 20% of all claims . What’s worse? Providers only rework 40% of those denials.  That’s money left on the table and lost opportunities to promote financial sustainability. Fortunately, there’s a defense: Partner with a team of highly-experienced accounts receivable (A/R) and denial management professionals to improve clean claim rates and recover hard-earned revenue.

Global Healthcare Resource’s strategic approach maximizes your recovery efforts to ensure revenue integrity. Using deep industry expertise, our accounts receivable follow-up and denial management team works with insurance companies to correct and refile as many claims as possible, restoring revenue and profitability so you can focus on providing high-quality patient care.

 

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In addition, Global Healthcare Resource’s courteous patient contact specialists  call patients from our secure call centers to educate them about remaining balances, discuss potential payment plans, and collect payments.

With more than 25 years in the industry, we have refined the medical billing A/R follow-up process to ensure optimal reimbursement. Our experts leverage best practices to reduce days in A/R and meet or exceed industry benchmarks. 

Accounts Receivable Auditing Services for Medical Billing

Global's A/R team runs regular audits to identify problematic patterns within your reimbursement cycle and provide insights on how to improve compliance, drive efficiency, and enhance revenue integrity.

Our strategic approach centers on a thorough audit of your medical billing accounts receivable procedures, including:

  • Insurance claim accuracy and submissions
  • Claim resubmission procedures
  • Compliance with coding guidelines
  • Coding accuracy
  • Automated charge posting

Outsourced A/R Denial Management Services

Optimizing your claim denial process and minimizing your overall denial rate expedites reimbursement and enhances your business's cash flow. Our professional denial management approach encompasses these essential steps:

  1. Evaluate denial types and frequency to identify common denial trends.
  2. Investigate the reason for each denial, including data and coding accuracy, policy coverage, and delayed submissions.
  3. Categorize denials to increase efficiency.
  4. Correct and resubmit claims.
  5. Monitor performance and adjust strategies as needed.

Global Healthcare Services customizes denial management services based on your project's needs. To explore our team's capabilities, learn more about the specific denial management services we offer below. 

Medical Billing Denial Management

While claim errors can occur at any stage of the revenue cycle, some of the most common causes for denials include: 

  • Inaccurate or omitted patient data
  • Missed filing deadlines
  • Coding-related errors
  • Unauthorized procedures
  • Duplicate claims
  • Conflicting coverage when patients have more than one policy

The good news? Almost all denials are preventable, and  providers can significantly reduce front-end errors by automating scheduling, eligibility verification, prior authorization, and patient demographics.

Outsourcing patient eligibility verificationmedical billing, A/R follow-up, and denial management to a trained team empowered by automation improves your operation's efficiency and reduces your claim denial rate.

Coding Denial Management Services

The Global Healthcare Resource denial management team includes highly skilled medical coders committed to data and revenue accuracy. Our process includes: 

  • Evaluating clinical documentation
  • Reviewing and/or assigning correct medical codes
  • Resubmitting amended claims

The medical codes our team assigns undergo strict internal and external auditing processes to ensure we maintain our 98% accuracy rate.

Telemedicine A/R Follow-Up

Given the complexity of ever-evolving telehealth guidelines, organizations must implement proactive strategies to address and avoid denials. Global Healthcare Resource helps you address common billing issues so you can continue to provide these in-demand services without experiencing cashflow disruptions.

Benefits of Outsourcing Accounts Receivable

When you outsource your accounts receivable management to Global Healthcare Resource, our team operates as an extension of yours, affording you several benefits:

  • Reduced claim errors: With a medical billing and coding team dedicated to A/R follow-up and denial management, we enhance claim accuracy and reduce denial rates.
  • Fewer cashflow disruptions: Our streamlined process minimizes errors to ensure you receive reimbursement as quickly as possible.
  • Lower department expenses: Partnering with our team is more cost-effective than recruiting, hiring, and training in-house A/R follow-up employees.
  • Enhanced patient satisfaction: Our highly trained and courteous A/R engagement specialists conduct medical billing follow-up calls that engage patients and put them at ease.
  • Advanced coding systems: Our accomplished coding team promotes coding accuracy and compliance, clean claims, and timely reimbursement. 

Your Trusted RCM Company for A/R and Denial Management

At Global Healthcare Resource, we leverage our immense industry experience to deliver the best A/R management services. We foster a collaborative partnership to ensure your organization's success. 

Our Global Academy-trained team spans the U.S., the Philippines, and India, giving you access to 24/7-hour service delivery. We never subcontractor our work.

Reach out to us today to learn more about our A/R follow-up and denial management services.

 

 

 

Frequently Asked Questions

What is accounts receivable follow-up, and why is it important for healthcare providers?

Accounts receivable follow-up is the process of monitoring and managing outstanding payments owed to healthcare providers for services rendered. This process is crucial for healthcare providers because it:

  • Ensures Timely Payments: Regular follow-up helps to identify and resolve any issues that may delay payments, ensuring that providers receive reimbursement promptly.
  • Improves Cash Flow: Effective follow-up reduces the days in accounts receivable, enhancing the organization’s cash flow and financial stability.
  • Minimizes Bad Debt: Proactive follow-up can prevent accounts from becoming uncollectible, reducing the risk of bad debt and improving overall financial health.
How can effective accounts receivable follow-up improve my organization's financial performance?

Effective accounts receivable follow-up can improve an organization’s financial performance by:

  • Increasing Collection Rates: Consistent follow-up increases the likelihood of collecting outstanding payments, leading to higher revenue.
  • Reducing Write-Offs: By addressing issues early, organizations can minimize write-offs and improve their bottom line.
  • Enhancing Operational Efficiency: Streamlined follow-up processes reduce administrative burdens, allowing staff to focus on patient care and other critical tasks.
  • Providing Financial Insights: Regular follow-up generates valuable data on payment trends and patient behavior, enabling better financial planning and decision-making.
What is the role of accounts receivable services in the healthcare revenue cycle?

Accounts receivable services play a vital role in the healthcare revenue cycle by:

  • Managing Billing Processes: Ensuring accurate and timely billing for services rendered, which is essential for prompt payment.
  • Tracking Payments: Monitoring outstanding accounts and following up on unpaid invoices to facilitate timely collections.
  • Resolving Disputes: Addressing any discrepancies or disputes with payers to ensure that claims are paid correctly.
  • Reporting and Analysis: Providing insights into accounts receivable performance, helping organizations identify trends and areas for improvement.
What factors contribute to delayed payments in accounts receivable?

Several factors can contribute to delayed payments in accounts receivable, including:

  • Claim Denials: High rates of claim denials due to coding errors, incomplete documentation, or eligibility issues can slow down payment processing.
  • Inefficient Billing Processes: Outdated or inefficient billing practices can lead to delays in invoicing and follow-up.
  • Patient Payment Responsibility: Increased patient financial responsibility, such as high-deductible plans, can result in slower payments from patients.
  • Payer Delays: Insurance companies may have their own processing delays, impacting the timing of payments to providers.
What are the benefits of outsourcing accounts receivable services?

Outsourcing accounts receivable services offers several benefits, including:

  • Cost Efficiency: Reduces overhead costs associated with maintaining an in-house accounts receivable team.
  • Access to Expertise: Leverages specialized knowledge and technology from third-party vendors to optimize collections and billing processes.
  • Improved Cash Flow: Streamlined processes and dedicated follow-up can lead to faster payments and improved cash flow.
  • Scalability: Allows organizations to easily adjust services based on patient volume and changing needs.
  • Focus on Core Operations: Frees up internal staff to concentrate on patient care and other essential functions.
What are the long-term financial benefits of maintaining a healthy accounts receivable process?

Maintaining a healthy accounts receivable process can yield long-term financial benefits, including:

  • Sustained Revenue Growth: Consistent collections lead to stable revenue streams, supporting organizational growth and expansion.
  • Reduced Bad Debt: Effective management minimizes the risk of uncollectible accounts, improving overall profitability.
  • Enhanced Financial Stability: Improved cash flow and timely payments contribute to a stronger financial position and better creditworthiness.
  • Informed Decision-Making: Accurate accounts receivable data provides insights for strategic planning and resource allocation.
How do you handle the transition of existing accounts receivable processes to an outsourced model?

Handling the transition of existing accounts receivable processes to an outsourced model involves several key steps:

  • Assessment and Planning: Conduct a thorough assessment of current processes and identify areas for improvement. Develop a detailed transition plan outlining timelines and responsibilities.
  • Communication: Communicate with internal staff and stakeholders about the transition, addressing any concerns and outlining the benefits of outsourcing.
  • Data Transfer: Ensure secure and accurate transfer of all relevant data, including patient accounts, billing histories, and outstanding invoices, to the outsourcing partner.
  • Training and Integration: Collaborate with the outsourcing partner to train staff on new processes and integrate their systems with existing workflows.
  • Monitoring and Evaluation: Continuously monitor the performance of the outsourced accounts receivable services and evaluate their impact on financial performance, making adjustments as needed.

The integrity of your data is our #1 priority.

SOC 2 Type 2 Compliant.

SOC 2 Type 2 audits determine how well an organization safeguards customer data and how those controls operate over a 9-month (minimum) time frame. Reports are issued by third party auditors who review the following principles: Security, Confidentiality & Availability. Global Healthcare Resource is proudly SOC 2 Type 2 compliant. 

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SECURITY 

The security principle addresses whether an organization's system is protected (both physically and logically) against unauthorized access.

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AVAILABILITY 

The availability principle addresses whether the services an organization provides is operating with the type of availability that client's expect.

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CONFIDENTIALITY 

The confidentiality principle addresses the agreements made with clients in regard to how their information is used, who has access to it and how it's protected.

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