Medical Accounts Receivable Services

Accelerate claim recovery and strengthen your cash flow

Accounts Receivable Follow-Up & Denial Management Solutions

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.

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

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

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Our Denial Management Process

Optimizing your claim denial process and minimizing your overall denial rate expedites reimbursement and enhances your organization’s cash flow. Our professional denial management approach encompasses the following essential steps:

Step 1

Evaluate denial types to identify common trends.

Step 2

Categorize denials by type (ex: data and coding accuracy, policy coverage, and delayed submissions).

Step 3

Correct claims and resubmit before timely filing dates.

Step 5

Monitor performance and adjust strategies as needed.

Coding Related Errors

Our A/R follow-up and denial management professionals have a minimum of 3-5 years of experience working with claims and understanding the complexities of revenue cycle management and medical coding. The denial management team leverages their coding expertise to pinpoint errors and support accurate resubmission.

Evaluating Clinical Documentation

Reviewing and assigning correct medical codes

Resubmitting amended claims

Benefits of Partnering with Global Healthcare Resource

When you transition your accounts receivable management workflows 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. Global has vast experience in hospital, post-acute, nephrology, cardiology, and many other healthcare settings, ensuring we have the expertise to meet your organization’s unique needs.

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

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

Frequently Asked Questions

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.

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.

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.

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.

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.

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.

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.