Aging Accounts Receivable is a thorn in many behavioral health facilities and hospitals sides. These are the accounts that categorize a company’s accounts receivable according to the length of time an insurance claim or patient balance has been outstanding. Basically, the invoice or bill hasn’t been paid in a long time.
The Accounts Receivable Aging Report
Hospitals and mental health facilities need to run reports on accounts receivable. This is called the Accounts Receivable Aging Report. This report tells a hospital or facility how long insurance claims and patient balances have been past due. Many times, they represent a percentage over 120 days. However, if your percentage is high, your billing department is not doing well.
How do you achieve good financial health? The hospital or behavioral health facility must perform Aging Report follow-up without any interruption or delay. Following on the pending accounts and reviewing the denied claims is the only way to generate high revenue while ensuring a better aging report.
Aging Accounts Receivable – Struggle for Payments
Hospitals and behavioral health facilities struggle with getting these paid for a number of reasons. Because we are a revenue cycle management company, we often receive calls from behavioral health facilities. Many of these calls require assistance with their aging accounts receivable. In many cases, we find behavioral health facilities losing at least six figures of reimbursement on a monthly basis. And these are typically small, rural facilities.
As these accounts age, or get older and unpaid, it becomes harder to claim the payment from insurance companies. Obviously, your facility cannot afford to lose this revenue because of the bad processing on the back end of your current revenue cycle management.
Finding the Problem
- Broken Processes
- Employee Capability & Expertise
We are now working in a modern world where nearly all claims should submit electronically. A high percentage of follow-up takes place online through payer portals, and most payments post electronically. Excuses for claims that remain in accounts receivable beyond 90 days should be few and far between. The presence of consistent Aging Accounts Receivable should be enough evidence that your revenue cycle team is not effectively doing their job. If they are beyond the 90-day threshold, that should raise a red flag.
In many cases, broken processes are the cause of these situations. There are likely issues with the initial claim submission process. Proper edits need to be set up in the clearinghouse to ensure your clean claim. Re-examine the procedures for following up with a claim. Someone should be checking the claim status right away.
Denial management is another issue. Someone should be working the denied claim instead of just pushing the claim back out to be denied again.
Do you have problems with Aging Accounts Receivable? You will probably find a broken link in your claim submitting process, follow-up, or denial management. If you are questioning whether your manager is capable of adequately assessing how these areas are functioning, you may need to identify a vendor that you can contract with to provide an independent assessment.
Employee Capability & Expertise
Behavioral Healthcare is constantly changing with technology, Federal regulations, and the processes in which a patient receives treatment. Your staff should receive continuing education to keep up with these changes. Your billing staff needs to be qualified to understand the needs of the job.
The right person should be knowledgeable about billing, especially in this modern world. The right person needs to be tech-savvy to work efficiently within the systems that your facility has in place. Let’s face it, paperwork is so 1980. If your staff has the tools necessary to be successful and your process still isn’t working, it might be time to examine whether you have the right people in-house, or if you should look to a third party for some help.
Solutions for the Problem
While these are just a few reasons why your Aging Accounts Receivable are, well, aging, there could be more reasons. These are just the top reasons we have seen. Typically, finding solutions to these problems will help you to find solutions to the other issues.
If you are looking to get rid of your in-house billing, or want someone to educate and train your current staff, Synergy Concepts is the right choice. Our experience and efficiency with our amazing team are perfect for your behavioral health facility.