Tackle your billing backlog to increase cash flow

Practices are struggling to maintain cash flow in the aftermath of the COVID-19 outbreak.

The pandemic and its resulting social distancing and visit postponement requirements caused patient volumes to plummet. According to an April 7 MGMA Stat poll, 97% of healthcare leaders reported a drop in patient volume.

As your practice builds back up to pre-pandemic patient levels, you can boost cash flow by taking a look at your billing backlog and adjusting medical claims processing accordingly.

Here are five tips for working medical claim denials to get you started:

1. Run an aging by carrier to identify carriers that have the shortest timely filing limitations.
2. Review your claims outstanding for carriers based on the dates closest to timely filing deadlines, and then by balance — working from highest to lowest.
3. To address more claims in less time, work claims based on denial trends. An example of a denial trend would be eligibility issues that arise when Medicaid or Medicare beneficiaries fail to send a claim to the correct payer. Another example would be issues caused by codes that require modifiers and that use alerts to remind the charge poster when to apply modifiers. By focusing on the larger trend at work, you can make headway on multiple claims.
4. Similarly, working the patient’s entire account — not just one claim at a time — will allow you to cover more ground. Often a problem that affects one claim will affect multiple claims for a patient, especially when it comes to eligibility or registration. When making corrections for a patient, see if you can correct other open balances with the same fix. This will result in more efficient medical claims processing.
5. After a review is complete, and all claims have been worked, make the necessary adjustments to claims that are not collectable. You may be unable to collect on certain claims for a variety of reasons — missing prior authorizations, timely filing denials, and bundling denials among them. Taking this step will help you get a true understanding of your collectable accounts receivable.

Applying these healthcare claims management tips can help your practice meet goals for key performance indicators (KPIs) such as days in A/R and — if the claims are greater than 60 days — 0-60 aging. Greenway Revenue Services focuses on these and other KPIs most important for reimbursement.

Partnering with Greenway Revenue Services gives you access to consultation, expertise, and resources to help you simplify billing and identify new revenue opportunities. For urgent cash flow protection needs, consider GRS Express, our new rapid relief solution focused on critical aspects of the revenue cycle.

In addition, a clearinghouse service, when integrated with a practice management system, can streamline connections, improving medical claims validation and offering greater control.

If your practice struggles to manage collections on its own, consider enlisting a partner to help with these functions. Such a partnership can provide healthcare claims management, address staffing-related challenges, and improve your financial standing in a challenging time.