How can RCM staff effectively manage accounts receivable?

1 Track and analyze AR metrics

Managing AR effectively requires tracking and analyzing key metrics that indicate the health and performance of the practice's billing and collection processes. Common AR metrics include Days in AR, AR aging, Collection ratio, Denial rate, and Write-off rate. By keeping an eye on these metrics, RCM staff can pinpoint the sources of AR problems, such as coding errors, claim rejections, payer delays, patient non-payment, or staff inefficiency. Additionally, they can measure their performance against industry standards and set realistic goals for improvement.

2 Implement effective follow-up procedures

An important step to manage AR effectively is to implement effective follow-up procedures for both insurance and patient payments. RCM staff should create a clear and consistent policy for submitting, verifying, and appealing claims, as well as communicating with payers and patients about the status of their accounts. Best practices for follow-up procedures include submitting claims electronically within 24 hours of service, verifying claim receipt and status with payers within 14 days of submission, appealing denied or underpaid claims within 30 days of denial notice, sending patient statements and reminders within 30 days of service or insurance payment, offering multiple payment options and incentives such as online payment or discounts for prompt payment, and monitoring and collecting overdue accounts within 90 days of service or insurance payment. By following these procedures, RCM staff can reduce the days in AR, increase the collection ratio, decrease the denial and write-off rates, and improve the patient experience.

3 Use technology and automation

A third step to manage AR effectively is to use technology and automation to streamline and optimize the billing and collection processes. RCM staff should leverage the capabilities of their practice management software, electronic health record system, and other tools to automate tasks such as eligibility verification, charge capture, coding, claim scrubbing, payment posting, and reporting. This will not only improve accuracy and efficiency in the work, but also reduce human errors, delays, and costs associated with manual processes.

4 Train and educate staff and patients

A final step to manage AR effectively is to train and educate staff and patients on the billing and collection policies and procedures. RCM staff should ensure that they and their colleagues are updated and informed on the latest coding and billing rules, payer policies, and industry trends. They should also provide regular feedback and coaching to each other to improve their skills and performance. Furthermore, RCM staff should educate patients on their financial responsibilities, such as copays, deductibles, coinsurance, and balances. They should also explain the billing process, the payment options, and the consequences of non-payment. By training and educating staff and patients, RCM staff can foster a culture of accountability, transparency, and collaboration, as well as increase the compliance, satisfaction, and loyalty of both parties.

5 Here’s what else to consider

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