Changing Payment Methods:
At this time of US healthcare evolving into different payment methods and moving from traditional Fee for Service payments, it is important for billing companies to ensure that their end clients get paid all their claims either by insurance payments or patients to maximize their revenue and reduce write off of unpaid claims due to passing appeal limit and timely filing limits.
On the other hand, Billing companies also need to ensure that every claim is paid the correct amount as per the Fee Schedule, Contracted rate, UCR etc. and are not underpaid. Underpayments and failure to appeal on underpayments cause significant revenue loss to providers.
In order to achieve the above, a very strong Accounts Receivable management team is needed who follow up on every claim till they get paid in full. However due to resources crunch, time challenges and efficiency uses, lot of money is lost by the provider when AR follow up or Appeals are not done timely and effectively.
Even the strongest AR teams of AR follow up experts or denial management experts tend to focus on high dollar claims and since practice has a large volume of low dollar claims, several claims pass through the crack which either sit in the AR inventory and inflate AR days or gets written off. Writing off such claims makes the AR days look healthy but still does not support the practices cash flow.
AR Management Team – Automation:
A robust and technically advanced AR Work Flow Management tool (WFM) helps the AR team to automatically prioritize and work on accounts on various parameters such as Insurance filing limit, appeal limit, dollar value etc. It also helps the AR team to trend and identify global issues by insurance, by provider, by procedure or by denial which helps the AR team to address multiple claims at the same time leading to increased productivity and quality.
It also helps the Billing company with dashboards with different metrics like Unworked claims, number of touches to resolve a claim, claims that are missed follow up on due dates, break up of AR issues by different categories like Coding, Credentialing, Billing etc. which helps to identify the issues across different departments and provide training, corrective and preventive actions to ensure maximum reimbursement.
Most importantly the WFM tool provides Clean claim rate (First pass ratio), payments realized through AR efforts (follow up calls, Telephonic/ paper appeals) and through patient statements. Thus an effective AR WFM tool will ensure that no claims are passing through the timely filing and appeal limit deadlines which are made stringent by the insurance companies.
eWORKS – The Solution!
e-care’s AR WFM tool “eWORKS” is a robust and sophisticated tool which helps all e-care’s clients to enhance their cash flow and reduce AR days significantly. It is developed by e-care’s technically skilled team of Subject Matter experts who have 20+ years of experience in AR and Revenue Cycle Management along with extremely qualified software professionals. eWORKS provides state of the art technology for the Billing companies in turn to their end clients, providers to get maximize collections for the charges billing to insurance carriers and patients in a timely manner.
To know more about e-care and eWORKS, call us at 813-666-0028 or email us at firstname.lastname@example.org or visit our website www.ecareindia.com.