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What to look for in your Medical Billing Reports, to understand the recurringly high Account Receivable (AR) Rate?

A high AR rate depicts negative Medical Billing performance. Improving AR rate for efficient claim management.

AR reports are used to monitor and correct a Medical Practice’s AR rate. Reports focus on aging buckets by payer or CPT codes, but other factors are crucial in AR analysis. Factors reveal hidden billing performance impacting AR rate. If your AR reports do not include the following, then your AR analysis will likely be flawed.

Here are 3 areas that should be analyzed in an AR report to better understand the reasons behind a high AR rate,

Lag time

  • Delayed Claim Submission
  • Patient Statement Lag time

Reason behind a high AR rate

  • Claim in Process
  • Denied Claims
  • Appeals
  • Incomplete Claim Data (Claims not submitted due to missing information)
  • Pending patient AR

Days in AR

illustration of 3 indicators to understand your Account Receivable (AR) Rate

3 indicators to understand your Account Receivable (AR) Rate

Lag time

Lag time is the days between the service date and claim submission.

Delayed Claim Submissions

A higher lag time lowers the AR rate. Tracking service dates, not just submission, shows reimbursement picture. This clarity will help calculate the AR rate and, hence, improve it.

Patient Claim Lag time

Patient statements created but not submitted increase AR days due to lag time.

Reasons behind a high AR rate

Denial Rate

Tracking denied claims and recurring denials reveals the AR rate.

A good practice to prevent recurring denials is to analyze the list of CPT codes for the claims that are denied. Often it happens that billers submit the same CPT codes without rectifying the issue. Identifying errors prevents recurring denials, saving time and improving AR.

Appeals

Tracking resubmitted claims after corrections reveal reasons for high AR.

Mostly, the AR rate is tracked back to denied claims, while appealed claims are left out of the picture. This presents an incomplete and unclear report. Track denied and appealed claims to understand AR rate better.

Incomplete Claim Data (Claims not submitted due to missing information)

Often, claims are put aside due to missing or incomplete information. These claims are pending to be submitted until the information on them is completed. Delayed reimbursement increases AR days.

Claim in Process

Claims that are submitted and are under process are often left out while calculating the AR rate. This affects the authenticity of the AR report. Missing info leads to inaccurate AR calculations, hindering improvement.

Pending Patient AR

Payments pending from the patients’ side also result in a high AR rate. Include missing info in AR reports for accurate insights.

Days in AR

Usually, reports show an average total number of claims that are pending to be reimbursed. Break down pending claims by the payer to identify and fix underlying causes. The infographic simplifies key points for understanding the AR rate.

AltuMED is a Medical Billing Service and Solution Company that understands the importance of prompt, systematic Medical Billing Performance Analysis. Why not contact us for a complimentary analysis that can help us understand the reason for increase in your AR rate?

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