Old A/R Cleanup
We bring to life old & unlikely collectable claims for which you are ready to give up by writing them off.
We will work on very old aging making that extra unique work which will pay off your efforts.
Timely follow up and appropriate action is most important in retrieving the old aging. One has to be very much experienced and professional to deal with insurance agents to make sure none of your hard earned money is left on the table just because no one made the right effort.
Our in house claim follow up tools not only keep us up-to dated but our clients as well. We strive for your hard earned money till the last outstanding penny is retrieved. In order to achieve such high goals a professional and dedicated team is required who is willing to take away your pain and relax you by improving the cash flow of your practice. Who consider your practice as their own and make sure your spent time is justified by incoming revenue.
Today many providers come across to a situation where the numbers of patients they see increase significantly while the reoccurring cash flow is stuck to the point where it was few years back. This could only lead to one condition that is increase of outstanding aging and eventually more and more balance in 180 days bucket. This is a drastic condition and working with only one or two individuals in your office to clean this huge mess is substantially not good enough to carry out this burdensome work in a timely manner. It will only increase the aging and create more and more backlog.
Cleaning old aging is time sensitive, it takes a lot of time to research, correct, appeal and or re-file the claims than might be anticipated. Thus instead of an individual or two, you need a dedicated team who can effectively work with insurances in a timely manner and can take actions promptly. We not only have a professional team and strength but we devise a unique way to retrieve your lost money and reduce the old aging, thus improving your cash flow.
We work in multiple steps to clean the old aging
Printing the Old Aging and Analysis Report
The very first step is to generate a report of all the outstanding claims and then custom sort it by insurance companies. Consideration of timely filling limit for each insurance is a vital part. No one would want to lose any claim due to timely filling. This is most embarrassing. So we also sort out the aging based on timely filling limits of different insurances. Insurances having lesser filling limits require quick submission and urgent follow-ups. So we assign a dedicated team to work on your aging rather than one or two individuals.
Setting Guidelines and Following up with Insurances
Next step is to set a guideline, which claim needs to be followed up and what can be written off as per provider guidelines and specialties. Determine the correct HCPC modifier combination, exact allowed amount as per provider contract and specialty. Then follow up with insurance companies and making sure the reimbursement on each and every claim is as per guidelines and provider contract. Our experienced and dedicated account receivable team carryout a complete and through follow up and collect all the necessary information. An Excel work book is prepared which is shared with clients on weekly basis.
Re-filling Claims, Sending Appeals and Medical Records
Once we will have a complete follow up of the practice along with set guidelines, our next step is to re-¦le the not on file claims electronically which will reach the insurance companies within 24-48 hours. The appeals process and addresses for paper claims may vary from plan to plan and from one state to another so that’s tricky. Our experienced account receivable team makes sure to obtain correct and exact address while following up.
Effective, Aggressive and Timely Follow Up
Next step would be to aggressively follow up on the appeals, reprocessed and resubmitted claims. An aggressive and timely follow up is necessary to make insurances pay what they owe. The claims will be processed and paid as quickly and accurately as the follow up will be. This needs an experienced team who has day after day experience of tackling the insurance company’s representatives, who know how to deal with them and how to make every single claim pay.
Posting the Payments and Closing the Claim
Lastly, every single payment is posted and write-offs/adjustments are made as per provider/client guidelines. Statements are generated and sent to patients wherever any patient balance is due. Paid and posted claims are closed.
A weekly posting report is shared with clients so that he has a clear picture of what’s going on and where does his cash §ow stand.
Physician Credentialing
Credentialing is the backbone of optimum revenue cycle management.
One of the frustrating issues practices always deal with is ¦nding out that you are not participating with insurances to which you are ¦lling claims to. The result leaves many providers with patients that they can no longer see. Thus your practice needs to be up to dated with health care industry& must have a partner that can assist with credentialing.
The process of provider credentialing can at times be overwhelming as well as extremely frustrating due to process complications. In ASPECT, it is our vision to cover all aspects, keeping in view the minor details. The as long process is required for the application so we assign a dedicated manager to your projects who ensures to make calls, submits applications & follow up well in time. We request & obtain new fee schedules annually to ensure that reimbursements are in accordance with the contracted rates.
Credentialing is an essential part of your practice. Whether you want to setup a new practice or add more providersto your existing practice, you need to credential it up front so that you don't lose any money.
When to Credential
- Whenever you need to setup your own new practice.
- When you have to add a location.
- When you add a new provider to your existing practice.
- Whenever you want to become in-network with a new insurance.
- Whenever you change your address.
- Whenever you join a new practice.
- Whenever you have to update existing information in insurance records.
Patient Eligibility Verification
Need to change
Being able to verify patient’s insurance eligibility & benefits information in a timely manner is critical. In order to do so consistently & accurately; not only efficiency but Cost effectiveness is what you required. We simplify the problem for you by creating completely separate department who is dedicated to do this work for you.
Obtaining eligibility & benefits information can at times become tricky due to a number of patient’s plan. Getting information about status of in or out of network within patient plan with providers, different specialties may have different benefits, deductibles can be tricky & their applicability may vary from one specialty to another. Our highly trained and dedicated department is vastly experienced and professional in obtaining the accurate information.
Understanding obtained benefits is also delicate, it needs proper and easy to understand reporting. We send organized and comprehensive reports to providers. Eligibility and bene¦ts verification reduces the number of claim delays and denials by receiving coverage response.
Medical Billing Audit & Consultation
Are you earning full value of your time?
There is always a room for improvement; you need to identify the key areas to improve. We can let you know by carrying an audit; you can maximize your pro¦ts.
We offer medical billing audits & consultation for medical practitioners or groups to help improve and streamline your practice. Auditing physician charges and billing practices are burdensome but it will typically yield improved claims management processes, cash §ow, and compliance with applicable laws and regulations.
There have been many modi¦cations to health care regulations and consequently risks within organizations must be effectively evaluated now more than ever. With this in mind, it is highly important to identify, prioritize and thoroughly evaluate risks that impact your organization.
We offer fee schedule evaluation and implementation to maximize your reimbursements. Billing the up-to dated fee schedule to both in and out of network is essential to maximize the revenue.