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Effective Denial Management with rigorously tested strategies

Denial of claims is a source of stress and a drain on the revenues of a practice. Therefore, denial management is a vital component of the Revenue Cycle Management and consists of four stages, namely, Identifying, Managing, Monitoring and Preventing claim denials.

Medical professionals submit millions of claims every day to payors. Most claims are reimbursed fully by payors. As per the AMA reports, claims denied on the first submission amount to 1.38% to 5.07% of the total claims. Even the best-performing practices see a denial rate of 5%. Denied claims represent delayed or lost revenue to a practice. (more…)

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Want to run RCM operations efficiently? Check out best practices!

Healthcare professionals train for years to treat patients and save lives while learning next to nothing about the business side of practices. Providers need to develop successful practice management processes to stay financially healthy. A medical facility’s entire financial process is termed Healthcare Revenue Cycle Management (RCM) and it covers management and collection of revenue from healthcare service to patients.

The healthcare revenue cycle starts when a patient makes his/her appointment to seek medical services from a healthcare provider. The process ends when claims are reimbursed and patient payments have been collected.  (more…)

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5 STRATEGIES TO DYNAMICALLY MANAGE ACCOUNTS RECEIVABLE DAYS

Account Receivables Days or AR Days indicates the time taken to receive payment on a claim. AR Days is a significant indicator of the financial health of a practice. In the United States, the average AR Days is 52.46 days. The lower the figure, the better is the financial situation. A lower figure means that there is more timely payment of claims and patient bills and cash flow is steady.

Know where you stand in terms of AR Days 

Compute AR Days in the following manner 

Average Daily Charges = (total charges for last 180 days) ÷ 180

AR Days = (total accounts receivables) ÷ (Average Daily Charges)

The billing department’s performance can be assessed by pooling the accounts receivables into “aging buckets” of 0-30 days, 31-60 days, 61-90 days and 90+ days.  (more…)

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