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Successful Receivables Recovery

Successful Receivables Recovery. Presented by terri Harrington ceo And tammy rose recovery specialist. Back ground .

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Successful Receivables Recovery

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  1. Successful Receivables Recovery Presented by terri Harrington ceo And tammy rose recovery specialist

  2. Back ground Terri Harrington - 20 years in the healthcare industry. Started out with CHAMPUS as a credentialing representative, became a contract liaison, to go on to assist providers with system conversion to becoming a consultant. Tammy Rose – WC adjuster at Insurance Company in Waterville, Medical Biller – Inland, Maine General, FMH Supervisor, Billing Manager, Billing, Manager, Registration, Small retirement Other Staff – Our staff consist of full time and per diems that have a wide variety of skills.

  3. What Resources do you provide your staff? • Coding software: Super coder, Encoder pro, etc. • ATB’s • Resource books: Medicare desktop reference manual, UB editor etc. • Insurance Directory:List of payer and current payer electronic ID’s • Provider websites: Availity, Connex, Navinet, Mainecare and Medicare list serves

  4. Building Relationships • Mutual respect: • Mutual Sympathy: • Patience: • Understanding:

  5. Documentation • As you would document for medical necessity you should document all efforts of your attempts to resolve you account balance. Try to avoid dangling carrots in order to get the person on the other side of the phone to see what your trying to say, show them with documented conversation etc. • Provide a script for your staff, the following is necessary to identify recovery attempts: • Number called: • Person spoke with: • Fax number faxed to: • Reference number: • etc…

  6. Provider Representatives • Know your provider representatives, invite them to your facility periodically to keep your staff up to speed regarding and changes . Be proactive, not reactive. • Each biller should keep a list of their payer specific representation. • When should you contact them? • What are the current payer issues that need resolution?

  7. Keep staff educated • Change is a constant • New rules and regulations • Internal systems • Don’t leave them hanging

  8. Success Stories • AR that has been written off. • Successful appeals • Recognizing trends

  9. Knowing Your Remittance Advice • Know your reason codes • Know which have to be appealed • Sometimes what they state are not what they mean • So you shouldn’t give up so easily

  10. Reconciliation Process

  11. Questions?

  12. Why Consider Outsourcing what’s the risk? • Annual AR spring cleaning – do you know where you money is truly at? • Cost and efficiency savings – billing complexities, different provider rules, bring in some outside ideas and knowledge. • Why just consider self pay outsourcing ? Why not consider accounts that you may lose to write off’s? Are they truly uncollectable? Why not let someone else review for a potential heart beat? • Not all AR is DOA, sometimes it takes another set of eyes. • Avoid a biller zombie apocalypse

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