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Accounts Receivable Follow-Up

Positively impact your bottom line.

The most valuable and critical phase of the revenue cycle process for any medical practice is the attention paid to following up on unpaid and underpaid claims.  Assuming a well “scrubbed” medical claim is filed, practices can typically expect 90-95% of claims to be paid correctly. The real value in the entire revenue cycle process is capturing that last 5% -10% of cash flow that eludes many practices.

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Let’s discuss how we can help you achieve the financial goals for your practice.

Practice vs Payer

The Practice vs Payer dynamic is naturally one of continuous conflict. Most insurance carriers utilize claims processing software designed to outright deny or “down-code” claims based on faulty assumptions such as diagnosis code not supportive of the CPT claim  chosen. More often than not, the automated software denial programs that are developed by large insurance carriers are sold and utilized by smaller insurance companies with the same end result – denial of claims due to faulty software assumptions. Understanding this dynamic is critical to solving the problem.

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We will work with you to identify inefficiencies in your practice and determine which functions will benefit from our direct oversight.

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Let’s discuss how we can help you achieve the financial goals for your practice.

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New Resources To Assist

Many practices do not have the time, resources and follow-up tenacity needed to get paid. The easiest claims are consistently cycled to keep minimum cash flow “alive.”  There never seems to be enough time to get on the phone or write and appeal the carrier with requisite documentation to reverse the denial. Excelling in this critical phase of the revenue cycle will elevate your practice’s financial position.

In-Depth Analysis

So, how can you tell if your practice is not being paid on these claims? Typically, an in-depth analysis of your aging along with a close review of resolved accounts, is the best starting point. Other indicators may be found by running a report of claims that are resolved (zero balance) and identifying when the charge equals the adjustment on the account. This means that no payment was received, and the account was written off in full. Another method is to review your detailed insurance A/R aging for accounts where the charge less patient co-payment equals the outstanding receivable. These of course are cases whereby the primary insurance has not paid.

Having the right tools to do the job are critical to completing any assignment successfully. Our staff has been highly trained and screened as the right personality type (those that despise conflict need not apply) to get the job done. It can be particularly difficult to find the right people that also possess the attribute of empathy when dealing with patients.  With 60+ years in business, we’re confident that we have the right formula for finding the best people to do this job!

Partnering For Your Practice's Future

While it may be tempting to engage outsource medical billing companies for short-term solutions aimed at addressing overdue accounts receivable, practice managers must carefully consider the practicality of such arrangements. Potential limitations for the overall success of the project include a weak audit trail, lack of in-depth analysis, not addressing the cause rather than the symptom of the problem, missed opportunities for process optimization, concerns about return on investment, and the possibility of operational disruption.

In many cases, customers may find that establishing a more extended and comprehensive partnership with their outsourced medical billing provider offers much greater benefits. By prioritizing long-term relationships and recognizing the complexities of the healthcare billing landscape, customers can maximize their financial health while minimizing operational disruptions and stress. Choosing a revenue cycle management partner that shares this commitment to long-term success is the key to a prosperous and efficient medical practice.

You Have Financial Goals.
We Help You Achieve Them.

Talk to us about meeting your practice’s financial goals with end-to-end RCM solutions.

Contact Practicefirst

Let’s discuss how we can help you achieve the financial goals for your practice.

Don't just take our word for it.

"We have been with Practicefirst for complete Revenue Cycle Services since our Hospitalist group was formed in January 2014 and have experienced excellent support and service while allowing us to grow and achieve our patient focused mission."

John Patti, M.D.
Infinity Medical of WNY, PC

"Practicefirst has been handling our Medical Billing and A/R follow up since January 2011. They have provided above average financial results with excellent customer service affording us the opportunity to focus on our most important goal, patient health!"

Debbie Chapman, Practice Manager
Pediatric Cardiology of WNY, PC

"I’ve used Practicefirst ‘s full-service Practice Management solution since 2005, including medical billing, coding, and documentation training. Monthly documentation and financial reports have been invaluable to our practices."

Greg DiFrancesco, M.D.
University Emergency Medical Services, Inc.


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