Increase REVENUE AND MANAGE A/R successfully

Why This Topic Matters

Accounts receivable problems can affect cash flow, staff workload, and reimbursement timeliness. The article explains operational areas that influence collections and highlights common payor-related issues that billing teams monitor.

Article Sections

1. Revenue cycle and staffing

   Introduces common sources of uncollected revenue and discusses staffing and workload considerations for billing operations. Focuses on operational planning rather than coding details.

2. Submitting accurate claims

   Covers claim timeliness, electronic submission, and front-end validation and exclusion review tools. Describes how billing teams can monitor claim accuracy before submission.

3. Tracking claim status and payment timing

   Discusses follow-up after submission, claim status checks, remittance review, and organizing secondary billing workflows. Emphasizes payment tracking and documentation.

4. Posting accurate payments

   Addresses contract management, fee schedule maintenance, payment posting, and verification of allowed amounts. Explains the importance of keeping payer information current.

5. Beware of Auto-posting

   Reviews software-driven payment posting and the operational concerns associated with automated workflows. Focuses on internal verification and secondary claim handling.

6. Ages Goals

   Summarizes target aging benchmarks for accounts receivable and references how different types of claims affect those benchmarks. Presents general performance goals for receivables management.

7. Appeals

   Covers documentation, denial and pend status follow-up, phone and written appeals, and patient authorization for appeals. Discusses common administrative reasons claims may be delayed or denied.

8. Forever Pended

   Addresses prolonged claim pend situations tied to support requests and coverage history review. Includes general escalation and state department follow-up considerations.