A recent MGMA poll, asking “How have your days in A/R changed in 2021?”, found that 49% of respondents said their time in A/R has increased in 2021. Thirty-seven percent (37%) said they stayed the same, but is that good? Only 15% said that it had decreased.

It is well known that the longer a debt goes unpaid, the harder it is to collect.  A study from Debt.com found that 50% of Americans have medical debt, increasing from 46% in 2020. They also found that more than half of that, 57%, owe at least $1,000, if not more, due to diagnostic tests, emergency room visits, or hospitalizations. In all, debt collectors hold approximately $140 billion in medical debt, not including credit cards and medical debt that hasn’t been reported to consumers’ credit reports yet.

The Good and the Bad

A number of the respondents shared some of the challenges and successes concerning their revenue cycle. For those practices whose A/R aging improved, the following are some of the reasons provided:

• New billing rules were implemented that increased the number of clean claims being sent out.
• Renewed enrollment in ACA marketplace plans reduced the number of uninsured patients, making collecting balances easier.
• Outsourcing all or portions of their revenue cycle management or utilizing new AI or machine learning tools to lessen repetitive tasks.

As for those practices that stated their A/R had increased:

• Lack of office staff to work outstanding balances or large learning curves for new employees.
• Some declared that they felt that payers played a role by issuing questionable medical claim denials and delays in reviewing appeals.
• Whereas prior authorizations were called out as an issue for several of the practices.

There are a couple of ways you can start collecting on these outstanding balances:

• Set up payment plans for those who can’t pay off large balances.
• Require the payment of copays, deductibles, or outstanding balances before providing services.
• Require down payments for expensive procedures like surgeries.

Your revenue cycle management is what keeps your practice doors open.  Part of that management is ensuring that your A/R is under control, with no more than approximately 14% of your aging over 90 days. If your revenue cycle management team is on top of things, then claims are going out clean, passing the clearinghouse the first time and denials are being appealed immediately.  They are managing to obtain eligibility before a patient’s visit so they can collect copays, deductibles, or amounts owed upfront. If not, then there is an issue that needs to be addressed.

Medical Staffing Shortage

One of the biggest issues the healthcare industry is facing right now is a shortage of staff, putting existing employees under intense pressure to do more and more administrative work – taking the focus off quality care for your patients. Another poll by MGMA showed that 42% of respondents stated that recruiting was their number one issue. Thirty percent stated that revenue was their top concern, but how can you increase your revenue if you don’t have the right people in place for your revenue cycle?

Outsourcing RCM Can Help

A way to help eliminate this issue is to outsource your revenue cycle management, allowing them to do what they do best while you and your staff focus on your patients. By outsourcing, you put an entire team of professional billers, coders, and A/R experts to work for you without the added expense of salary, training, or staff turnover.

At Billed Right we partner with you to ensure that your revenue cycle runs efficiently and effectively. With a team of AAPC certified coders and experienced billers, we are with you every step of the way. An additional benefit of outsourcing with us is that we provide reports weekly, monthly, quarterly, and annually so you know exactly what is happening and can keep track of your practice’s financial health.

We see our role as a strategic partner, not just a vendor, and work to optimize your entire revenue cycle to help you grow your practice!

To learn more about how you can partner with Billed Right for your prior authorizations please contact us today!