Medical Billing & Coding For Dummies
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In medical billing, the practice of following up claims after submission can reduce the number of days from submission to payment and thus, accounts receivable. Ideally, the claim should leave your hands within 72 hours after the date of service. That is when the payment clock starts and when you can start looking for that check to show up in accounts receivable (AR).

To help reduce your claim’s time in AR, state payment laws legislate the number of days in which a payer must pay a clean claim. Payer contacts usually have prompt pay clauses, as well.

Your billing software can help you keep track of how long a claim has gone unpaid by giving providers access to a number of reports. One of those is the aged collection ledger. This report reflects the individual payers and the patient accounts that are associated with each payer.

The report also indicates the age of the account in number of days; 30 days or less, 31–60 days, 61–90 days, 91–120 days, and so on. The report also shows the number of days allowed in AR per payer.

When looking at the report, look at the abbreviated version, which is the age of the accounts per payer, and do the following:

  1. Beginning with the payer with the largest number of accounts receivable outstanding, look at the payer’s accounts that are 30 days or less.

    Verify that these claims have been received.Doing so helps prevent timely filing issues later on.

  2. Looking at the oldest accounts, calleach payer and check the status of each account.

    Here are some questions to ask each payer you call:

    • “Has a claim number been assigned? If so, what is it?”

    • “What is the status of this claim?”

    • “When can we expect payment?”

    • “Are there any issues causing the claim to be delayed? If so, how can we fix them?”

    • “Is additional information needed?” If so, get a fax number and send the necessary information;then call back and confirm the receipt ofthe fax.

    • “With whom am I speaking, and what is the reference number for this call?”

  3. Work your way through the aged account ledger by looking at the accounts as they have aged and get the claims in process to pay.

    If you are responsible for the financial state of the aged accounts, the fewer the days in accounts receivable for each claim, the better you look.

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