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How Does a Specialty Pharmacy Billing Company Boost Healthcare Productivity?

Specialty pharmacies portray an essential role in managing chronic conditions. These conditions include cancer, multiple sclerosis, and rheumatoid arthritis. As these drugs are highly priced, any slight mistake in billing can instigate massive financial problems. Specialty pharmacy billing companies entail entails extensive knowledge of insurance protocols, coding updates, and prior authorization requirements. Outsourcing the billing process helps pharmacies reduce errors, improve turnaround time, and focus on the most important aspect,; which is getting patients the treatments that change lives.

The Price of a Wrong Step in Specialty Billing

One single prescription may cost more than $10,000. However, one miscode can significantly cause even more losses in your claim denial, hence halting treatment and putting pharmacy finances under pressure. According to the AHIMA journal, around 20% of medical claims are denied due to coding discrepancies, causing massive revenue loss across the healthcare sector. Hence, this statistic shows that the price of a single misstep is huge. Hence, to tackle these issues, the specialty pharmacy billing company comes into the picture.

Why to Hire a Specialty Pharmacy Billing Company

There are several reasons to hire a specialty pharmacy service. The reasons start from less claim denials to scalable solutions for scaling up pharmacies. Let’s discuss all the reasons one by one:

Less Claim Denials

Claim denials are among the biggest threats to pharmacy profitability. When claims are denied, the pharmacy must continue to pay their staff without reimbursement for services rendered. That’s where the professional billing staff checks check insurance eligibility meticulously and utilizes precise medication codes to ensure clean claim submission. This level of attention dramatically reduces denial rates, enhancing cash flow and ROI.

Effective Prior Authorization

Prior authorization is often regarded as one of the most difficult processes in pharmacy billing. This involves cross-checking patient insurance coverage, procuring medical records, and securing official approval from payers before dispensing drugs. Outsourcing billing firms take care of this full RCM process. They prepare and send all the documents needed, ensure that they are in line with insurer specifications, and make follow-ups until claim approval is achieved.

Reduced Operational Costs

It is very expensive for a clinic to manage an in-house team. Because you have to invest in training, offer salaries and benefits, invest in software, and continually educate. Outsourcing eliminates these costs. The third-party specialty pharmacy billing company already has trained coders, support staff, and equipment. Pharmacies only pay for the service they use, which in many cases is considerably cheaper than maintaining an in-house staff.

Scalable Solutions for Scaling Up Pharmacies

As specialty pharmacies grow, administrative tasks also grow. Expanding an in-house billing department is costly and time-consuming because the staff needs extensive training and more office space. Outsourced billing companies help with scalability. They can deal with varying spikes in patient volume without the need for added overhead. Scalability increases long-term expansion without disrupting operations or lowering service quality.

Financial sustainability forms the very foundation of quality healthcare delivery. Settling claims on a frequent basis and payments made on time enable pharmacies to invest in advanced technologies and maintain better stock levels of drugs. This will allow patients to receive drugs timely and the pharmacy to build a name for efficiency and reliability.

Why Choose a Specialty Pharmacy Billing Company?

The specialty pharmacy billing company manages complex billing activities, automates prior authorizations, and gets rid of costly inaccuracies, which may delay care or cost revenue. Due to reduced claim denials and fewer administrative expenses, pharmacies can focus on what they should, which is to provide great patient care. That’s why specialty pharmacies need to outsource to a reputable billing company to take care of their whole billing process. These experts can be highly helpful in streamlining the PA process and also the billing inaccuracies.

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How Healthcare A/R Services Help Minimize Payment Delays and Claim Denials

Every time a claim gets denied or delayed, it feels frustrating. It is like putting your hard-earned money on hold. This affects your cash flow as well as your entire revenue cycle. However, if you want to solve this problem, accounts receivable services can make a big difference.

These services are for helping healthcare providers in getting paid faster. Such services also reduce the rate of denials, improve the claims follow-up process, and help you to receive payments consistently. In this blog, we will discuss why denials happen and how you can stop them from happening.

Why do payment delays and denials happen?

Payment delays in healthcare typically happen for one (or more) of the following reasons:

Incorrect or incomplete claims – Even a small error in coding or patient data can lead to a denial.

Failure to verify insurance – If coverage isn’t verified in advance, claims may be delayed or rejected.

Late claim submission – A lot of payers have strict deadlines. If you miss them, you might face revenue losses.

Lack of documentation – Do not miss clinical notes and prove the medical necessity of the treatment, else it can trigger denials.

Poor follow-up – You should not take follow-ups for granted.

Denials don’t just happen occasionally, they are common. According to the American Medical Association (AMA), 7% of medical claims are denied at the time of first submission. Without a strong A/R process, those denials can pile up and turn into permanent revenue loss.

How can healthcare accounts receivable services help?

These services take steps towards helping you receive payments faster. Here is how:

Advanced claim scrubbing and submission

The A/R specialists check and review it for accuracy. This is known as “claim scrubbing”. In this process the specialists check whether the CPT codes are used properly, insurance and patient details are correct and if the relevant modifiers are used or not. According to experts, clean claims have a higher chance of getting approved, and the payments are processed faster.

Real-time eligibility check

One of the main reasons claims get denied is because the service is not covered by the patient’s insurance plan. But with A/R services, you do not have to worry about that. They use tools that check insurance eligibility in real time, so you and your front desk team can confirm what’s covered before the patient even shows up. That way, you avoid denials later on.

Denial management and appeals

A healthcare accounts receivable team knows how to handle claim denials and how to fix them. It can be an issue related to the payer guidelines, missing documentation, and coding inaccuracy. These experts review the claims, identify the issue, and correct it so that the claims can be resubmitted.

Automatic follow-ups and A/R recovery

It is easy to fall behind on unpaid claims that are 30 or 60 days old. But when you work with an A/R service, you don’t have to keep chasing them. They use smart tools and trained staff to keep track of those claims, spot any issues, and follow up quickly. That means fewer missed payments for you, and more steady cash coming into your practice.

Transparent reports and insights

The best A/R services don’t just fix today’s problems; they also help you avoid them. A reliable healthcare accounts receivable company gives you clear reports that show why claims are getting denied, which payers are causing issues, and how your billing is doing overall. With that information, you can make smart changes to your process and improve your cash flow over time.

Outsourcing healthcare accounts receivable services to the right partner

Not all A/R services are the same, so it’s important for you to choose the right partner. You should look for the following:

Scalability – If your practice grows, can they keep up with a higher number of claims?

Customer support – Can you easily reach someone when you have a question, or you need help?

Compliance – Are they familiar with the latest HIPAA rules, insurance policies, and government regulations?

Don’t be afraid to ask for proof of how they have helped other practices. Professional healthcare accounts receivable services should be able to show you real results and explain how they have solved problems for their clients.

You should not have to fight just to get paid for the care you have given. When you work with a trusted A/R partner, you can take the stress out of billing. You will spend less time fixing denials, making payment calls, chasing down claims, and more time seeing your money come back into your practice. If your current billing process isn’t working, it might be time for a healthcare accounts receivable company to step in and help you take control. Because waiting for a long time means getting stuck with the payments.

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How Specialty Pharmacy Billing Services Guarantee Higher ROI?

Specialty pharmacies deal with medications for severe conditions like cancer or uncommon diseases. The drugs are costly and billing for them is extremely challenging. Billing errors can result in not just revenue loss but also leave numerous patients dissatisfied. That's where specialty pharmacy billing services step in. They facilitate the pharmacies to get paid properly and timely, thus resulting in a higher healthcare ROI.

Specialty pharmacies handle expensive drugs. One prescription may cost more than $10,000 every month. Therefore, if billing is incorrect, the claim may get rejected. A rejected insurance claim will result in zero payment for the expensive drug. The AHIMA journal states that 20% of claims are denied because of coding errors. That's a lot of money left behind. That’s where the billing services come in to streamline the billing process. Their experts stay updated with all the new CPT and ICD codes to make sure no claim denial occurs.

Higher ROI translates to more reinvestment. Pharmacies can purchase more medicines, treat more patients, and upgrade their system accordingly. Without a good billing service, profits are reduced due to billing errors. The billing services utilize experienced personnel to minimize billing errors in lesser time, which ultimately results in higher ROI.

Top Benefits of Employing Specialty Pharmacy Billing Services

Lower claim denials

Claim denials are a huge problem for pharmacies. A denied claim is when the insurance companies refuse to pay. And then the providers have to pay their workers out of their own pocket. In contrast, outsourced billing experts carefully review all the details including patient insurance, drug codes, and doctors' approval in order to make an effective billing process. There is less denial when money comes in, so there is more ROI.

Reducing the speed of payments

Receiving quicker payments is the very essence of a thriving business. Nevertheless, the specialty pharmacy claims take weeks, sometimes even months, to process. But the billing services quicken this process. Their experts thoroughly comply with the HIPAA law to protect patient data. Besides, they are also aware of all the intricate details of the CPT and ICD codes so that no claim denial occurs. Hence, they not only quicken the payment process but also enhance patient satisfaction by providing accurate billing.

Assistance with prior authorization

Prior authorization is such a complicated process to handle. Additionally, it consumes a lot of time for the providers to resolve this complicated process because it involves verifying patient eligibility, insurance and much more. Therefore, the staff does not get ample time to deliver quality patient care. This is where the specialty pharmacy billing services can assist you. First, they collect all the patient's medical reports, doctor's prescription, and medication details. Then they establish a proper billing process following the regulations of various insurance companies. Thus, it simplifies the process of submitting claims and enhances healthcare efficiency.

Reducing operational cost

It is costly to manage an in-house billing department. It is because you need to train the staff and purchase costly software to make sure no claim denial occurs. However, specialty pharmacy billing services relieve you of this burden. Their experts do all the complicated billing operations for a small percentage of your revenue as they are previously trained, and the outsourced companies provide them with the office space. Hence, reduced costs translate into greater profit, hence enhancing the ROI.

Final Thoughts

Specialty pharmacy billing services are game changers. Their experts guarantee precise coding to reduce claim denials and accelerate the reimbursement process. Additionally, the in-house healthcare staff comes at a high cost. That is where the third-party billing services give you dedicated professionals who solely work on resolving your billing challenges. Therefore, you are able to minimize your attention on the billing process and maximize your attention on patient care.

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Understanding the New HCPCS Code G2211 to Enhance Cardiology Billing Accuracy

Cardiology practices are a whirlwind of activity. Doctors manage complex heart conditions while tackling piles of paperwork. Billing often feels like a hurdle that trips up even the best teams. That’s where HCPCS code G2211 comes in. Rolled out by the Centers for Medicare & Medicaid Services (CMS) in 2024, this add-on code is a lifeline for cardiologists. It rewards the effort of building long-term patient relationships. Here we will focus on the benefits of G2211 for cardiology and practical ways to use it correctly.

What Exactly Is G2211?

HCPCS code G2211 mainly deal with supplementary billing code for physician office and outpatient visits. It is all about dealing with CPT codes 99202 to 99215 for evaluation and management visits. CMS introduced it in the year 2021 on 1st January in order to value the work of ongoing patient care. In cardiology, it applies when a doctor is the main point of contact for a patient’s heart issues. This HCPCS code represents the duration of a cardiologist guiding someone with heart conditions. G2211 isn’t about how tricky the condition is—it’s more about the years of experiencing or dealing with the particular condition.

Why Cardiologists Need G2211

Heart care is a long and, in most cases, everlasting process. Conditions like high blood pressure or irregular heartbeats demand constant attention. Cardiologists tweak medications, order tests, and keep patients on track. G2211 recognizes this effort and fills a gap left by regular billing codes, which often miss the mental effort of long-term care. This code helps cardiology offices get paid for the full scope of their work.

Functionalities of G2211 in Cardiology Billing

G2211 applies when a cardiologist takes charge of a patient’s heart care over time. It’s perfect for managing chronic issues like angina or heart valve problems. The focus is on the ongoing bond, not a one-time fix. For example, a follow-up visit for a pacemaker patient qualifies if the doctor is their main heart care provider. But it doesn’t work for quick consults, like assessing sudden chest pain.

Furthermore, billing G2211 has some ground rules, like tagging along with office or outpatient E/M codes. Both new and returning patients qualify, as long as the cardiologist plans to stick with them long-term. Starting January 2025, CMS allows G2211 with some preventive visits, like annual checkups, if modifier 25 applies. Billing staff must avoid using it for short-term cases, like a second opinion. Following these rules keeps payments flowing smoothly.

Making Cardiology Billing More Accurate

Accurate billing keeps cardiology practice humming. G2211 helps by capturing the full effort of patient care. However, wrong usage, like using it for a one-off visit, leads to rejected claims. Hence, cardiology offices should train their staff to accurately spot when G2211 applies. They must regularly update billing systems to prompt for it alongside E/M codes.

New codes like G2211 can stir up confusion. Cardiologists must thoroughly write notes that show the patient’s history and ongoing care plan. For instance, a patient with atrial fibrillation needs records of regular visits. Some doctors worry about audits if their notes aren’t clear enough.

In addition, cardiologists must set up monthly reviews of denied claims to fix errors fast. Finally, billing teams must evaluate claims monthly to catch slip-ups. These habits boost the billing accuracy and revenue of the cardiology office.

How to Roll Out G2211 Accurately

Starting with G2211 is easier with a solid plan. Such as –

First, cardiologists should hold a team meeting to go over G2211’s rules. They must share CMS’s guides for clarity.

Moreover, groups like the American College of Cardiology offer coding tips and webinars. Cardiology billing teams must regularly follow such groups to ensure accuracy.

Heart doctors must keep detailed records, like care plans for heart disease. It will convince auditors that claims show a true long-term relationship.

Next, the administrative staff of cardiology offices must tweak billing software to include G2211 automatically with eligible codes.

After that, cardiology billing services must follow up on claim approvals and evaluate denials to spot patterns.

Finally, cardiologists must inform patients about possible extra costs from G2211.

These steps weave G2211 into practice without a hitch. Moreover, accurate implementation of these HCPCS codes will keep the practice compliant, saving them from audits and penalties.

Real Benefits for Revenue and Patient Outcomes

G2211 does more than pad the bottom line. Extra revenue lets practices hire more staff or buy better equipment. Moreover, cardiologists can purchase new monitors for heart patients or give community health talks to enhance their practices. Stable finances mean less stress for doctors, so they can focus on care. Patients gain from tighter bonds with their cardiologist, getting plans that fit their needs. Above all, trust builds when doctors stick with them throughout the process, fueling both stronger practices and happier patients.

Concluding Thoughts

HCPCS code G2211 values the hard work of sticking with heart patients over time. Cleaner billing means rarer denials and healthier reimbursements. The improved cash flow and shortened revenue cycle let practices grow and innovate. However, keeping internal billing experts is pretty expensive. It might break the banks of small cardiology offices. Here, outsourced cardiology billing services offer valuable and reliable solutions.

Third-party billing experts stay up-to-date on ever-changing coding guidelines. Their expertise ensures coding and billing precision, so the practice can get reimbursements right on time. It will guarantee streamlined cash flow and improved financial health. Best of all, the outsourced billing experts' free cardiologists to do what they love—help patients thrive. Cardiology offices in the US that nail G2211 stay ahead in a tough field. It’s not just a code; it’s a tool for better care and a stronger future.

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How to generate consistency with infusion billing

With auditing of outpatient infusion charges, missing documentation is one of the major causes of concern. It puts your claims submission process at a lot of risk and as such you need a genuine vendor who will be able to do justice and can change your reimbursement strategy and can make sure that everything is handled with complete propriety.

The biggest concern is to know how you will eliminate proven gaps at your front end which will be able to bring about a consolidated change and help you earn a definitive presence as a dedicated infusion service provider.

Creating a genuine roadmap and optimizing growth is all about connecting the dots and connecting the same with expertise and experience.

In fact, that is where all the difference gets made with a definitive vendor who will be able to change your financial future once and for all.

Thus, it is imperative that you opt for a vendor who has niche experience and consistency to change your complete ROI returns as a next gen dedicated healthcare services destination. But the question is how will you be detecting which are areas of flaws which are leaking your money for services rendered. Are the right procedural and diagnosis codes in use and is it making things work out for you and helping you gain competitive advantage?

Is outsourcing of infusion billing a valid idea

It is becoming increasingly difficult to find quality resources that will be able to deliver excellence and can change the way you are currently managing the details of infusion billing. It is crucial that you find a partner with intuitive knowledge of the latest practices which will be able to change your financial future once and for all.

The biggest vendors in the world of infusion are now looking for competent vendors who can make it work out for you and bring about a complete change in the manner you are working with your present day practice management requirements.

The ultimate need of the hour is to choose a disciplined partner with extensive knowledge of the claims adjudication guidelines and by which they change the way you are currently working with your reimbursement details. In fact, that can make a huge difference and make sure that all your collection strategies with infusion billing is in place and you are able to stand the test of time.

To start, it is imperative that the company shares some references and testimonials which will be able to give you the confidence that the company you are looking to work with has the knowledge and understanding of the latest infusion billing 2025 guidelines , knows how to use the right CPT codes, working out a strategy with checking of eligibilities and verification which will be enough to give you a complete picture on how the payments will be falling in place by resurrecting the front end jobs in ideal earnest.

It will be having a huge impact and as such it is needed that you find a vendor who will be able to do the same for you and make you look after your patients a lot better!

The advantage of working with SunKnowledge Inc

Our team has comprehensive knowledge on what makes us a robust destination for some of the largest infusion service providers of the country. Get to know how we optimize growth; create best in class processes which will change the reimbursement demands like none other. At just $7 per hour, we will be bringing out a genuine change and a complete infusion billing transformation.

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How Pre-billing improves Healthcare Accounts Receivable Management Service

A good billing process starts with proper pre-billing steps. You need to improve your pre-billing system for faster payments. This includes payments from both patients and insurance companies. Think of pre-billing as the base of a house. If the base is weak, the house will have cracks and problems. But if the base is strong, the house stays firm and steady.

This is why a good pre-billing process is so important. It helps catch errors early. It reduces claim denials. It speeds up your payments. It also lowers healthcare accounts receivable management services and keeps your cash flow smooth.

Now, you need to understand what pre-billing is. It plays a big role in improving your healthcare accounts receivable. Pre-billing helps you get faster payments and fewer errors.

It is time to know what pre-billing is and these steps improve healthcare accounts receivable.

What are pre-billing steps and how they improve healthcare accounts receivable management services

Pre-billing includes all the steps before you send the final claim to the insurance company. It begins with checking patient details. Names, dates of birth, and contact information must be correct. Next, check if the patient’s insurance is active and covers the service. Then comes prior authorizations. Some treatments need approval first. If you skip this, claims may be denied. Accurate coding is also very important. Each procedure needs the correct code to avoid rejection. Finally, charge entry must be done carefully. It records every service the patient gets. This helps you submit clean claims and keeps your pre-billing process strong.

When you follow these steps, your claims stay clean. Fewer mistakes mean fewer denials and quicker payments. A strong pre-billing process keeps your cash flow steady. It reduces resubmissions and follow-ups. Correct claims from the start also prevent overdue accounts and protect your revenue. You might wonder how pre-billing helps your healthcare accounts receivable services and why it needs more focus. Let’s find out.

Minimal claim denials

Most claim denials happen because of wrong or missing patient details. Even a small error, like the wrong birth date or insurance ID, can cause rejection. Pre-billing helps stop these mistakes early. It checks and fixes patient information before submission. This lowers denials, speeds up payments, and saves time on corrections.

Timely reimbursements

Clean claims get processed quickly. Payments come in faster. Fewer mistakes mean fewer rejections. You spend less time fixing errors. Fast payments improve your accounts receivable. They keep your cash flow smooth. You can pay your expenses on time. No need to chase payments. Your team can focus more on patient care, not fixing claims or tracking unpaid bills.

Reduced administrative burden

Fixing denied claims takes a lot of time. Every error adds extra work. A strong pre-billing process catches mistakes early. This helps payers process claims easily. Faster payments lower your accounts receivable. They also keep your cash flow steady.

Improved patient satisfaction

Pre-billing also helps with patient satisfaction. When billing is correct from the start, patients get clear and accurate statements. They understand what they owe and why. This builds trust and reduces confusion. Happy patients are more likely to pay on time. Fewer billing mistakes also mean fewer patient complaints. This saves your team time and keeps your practice running smoothly.

Many healthcare practices now use healthcare accounts receivable management services to lower unpaid accounts. Denied claims and slow payments hurt cash flow. They also increase unpaid balances. Fixing these problems takes time and effort. A good AR service helps you submit clean claims. It brings faster payments and fewer denials. It also cuts admin work and keeps your cash flow smooth. So, partner with the right healthcare accounts receivable management service to keep your AR low and your revenue steady!

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Outsource Health System Billing: The Perfect Solution Staffing Shortage

Power comes with responsibility. That's how U.S. health systems work. They care for millions, from heart treatments to cancer care. They keep America healthy. But billing keeps them running. A strong billing system keeps health systems financially stable. It also ensures great patient care. Even top health systems can struggle without a solid billing process.

Healthcare is facing a labor shortage. People talk about doctor and nurse shortages. But the shortage of billers and coders is just as bad. Health system billing is complex. It needs experts for claims, coding, and compliance. Without them, payments slow down. Revenue drops. Finding skilled billers is harder than ever. Big health systems are feeling the pressure. They are struggling to stay financially strong.

The following are the vital billing challenges that health systems often face due to a labor shortage.

Vital health system billing challenges due to staffing shortage

Shortage of expert medical billers and coders: Skilled billers and coders are in high demand. But there aren't enough. Hospitals and clinics struggle to hire them. This leaves staff overwhelmed. Long hours and heavy work lead to mistakes. Billing errors mean lost revenue and denied claims. The pressure keeps growing. Without enough help, health systems face financial trouble. A strong billing team isn't a luxury—it's a must for smooth operations and timely payments.

Increased administrative burden: Billing needs close attention. Every detail counts. But with fewer staff, work piles up fast. Backlogs grow, and payments slow down. Delayed reimbursements hurt cash flow. Your health system feels the squeeze. Late payments make daily costs harder to cover. Denied claims add more stress. A strong billing team keeps money flowing. Without one, financial stability suffers. In healthcare, time is money—especially when it comes to getting paid.

Elevated operational costs: Fewer billers mean higher costs. Salaries are rising. Hiring isn't cheap. Health systems spend more on recruiting and training. But turnover makes it worse. It's a tough cycle. More hiring costs mean less for patient care. Clinics and hospitals feel the squeeze. The pressure keeps growing. Without a stable billing team, revenue suffers. Every dollar spent on hiring adds to the struggle.

Increased denials and revenue gap: Without a strong health system billing team, claims get denied. Small mistakes in coding or paperwork can cause big problems. Payments slow down, and revenue drops. Hospitals and clinics feel the pressure. Every denied claim means lost money. Fixing errors takes time and effort. The financial impact grows fast. Poor cash flow makes it hard to cover costs. A good billing team keeps things running smoothly. Without one, staying financially stable becomes a challenge.

Staff burnout: Overworked billing teams feel the strain. Long hours and heavy workloads cause stress. Burnout happens fast. Tired employees quit, leaving big gaps. Hiring takes time and money. Health systems fall behind. The cycle keeps going. With fewer staff, the work piles up. Mistakes increase. Claims get delayed.

Slower patient services: Billing delays don't just hurt finances—they slow down patient care. Healthcare systems actually struggle a lot to manage resources, especially when claims take too long to be processed. The entire system slows down. A strong billing team ensures smooth operations. Without one, hospital staff members frequently become overburdened with the management of administration, therefore causing less time for patient care.

Many health systems are outsourcing. It's a smart choice. A health system billing partner keeps finances strong. It also frees up time for patient care. Experts handle claims, coding, and payments. This reduces errors and speeds up payments. No more staff shortages or training issues. Workflows improve. Revenue stays steady. In a tough industry, outsourcing brings stability. It lets you focus on patient care, not paperwork.

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Top 5 Gastroenterology Billing Errors and Their Effective Solutions

Are you facing significant claim denials due to gastroenterology billing errors? Are denied reimbursements affecting the cash flow of your gastroenterology clinic? Are you searching for the best solution to streamline your gastroenterology billing practices?

We have observed that about 5-10% of gastroenterology bills face claim denials due to some common errors. It affects the revenue cycles of gastroenterology clinics with increased accounts receivable. As a result, patient care gets hindered affecting overall patient outcome.

Furthermore, billing errors have several negative consequences for gastroenterology clinics. For example, they might face regulatory penalties and financial loss due to mistakes in invoicing. Now the question is what the most common gastroenterology billing errors are and how to address them. Here are the answers –

Erroneous Insurance Verification

Insurance verification is the initial step in the gastroenterology billing process. Operational staff of GI clinics need to ensure whether the prescribed treatments and medications are covered under the patient’s insurance plan. Many claims are rejected by payers due to the following clauses –

• Treatment not covered by the insurance plan • The patient is no longer eligible for insurance benefits • The patient utilized the maximum benefits allowed by the payer

Hence, gastroenterologists must employ expert and experienced billing specialists who have in-depth knowledge of insurance verification. Here, outsourced GI billing services offer the best solution. They will accurately verify the patient’s insurance coverage and ensure faster reimbursements.

2. Incorrect Patient Information

If billing associates make errors while collecting patient demographics, it will instantly result in claim denials. Billing experts must, therefore, take extra caution while recording the patient's name, address, date of birth, social security number (SSN), and insurance ID. They must be cautious in eradicating careless typing mistakes. Moreover, billing staff must verify the patient’s Electronic Health Records (EHR) and rectify unwanted errors (If any). Accurate patient information will accelerate reimbursement procedures.

3. Absent Prior Authorization

Prior authorization (PA) is an essential requirement for seamless reimbursement. Through PA, insurance payers agree to pay the healthcare expenses of the particular patient. However, securing a PA is quite challenging. Gastroenterologists must submit all-inclusive documents that justify the medical necessity of the prescribed treatment plan and medications. However, most claim denials and delayed reimbursements are caused by missing PA. To eradicate PA errors, billing specialists must accurately follow payer policies, regulations, medical coding, and documentation guidelines.

4. Error in Medical Coding

Gastroenterology coding experts have to work with a wide range of standardized medical codes. They must apply proper CPT, ICD-10-CM, and HCPCS codes so that treatments and procedures involving the digestive system get proper reimbursement. The in-house staff of gastroenterology clinics often apply outdated or mismatched medical codes that result in claim rejections.

Moreover, healthcare authorities frequently update medical codes that make the process even more challenging. Professional GI coders have in-depth knowledge regarding updated medical codes that perfectly align with the patient’s treatment plan. Hence, they can efficiently eradicate coding errors to ensure gastroenterologists get reimbursement on time.

5. Inaccurate Document Submission

Insurance payers reject a significant number of claims due to incomplete or missing documentation. GI billing services must submit comprehensive documents to validate rendered treatments. Payers have in-house medical experts who thoroughly check all submitted documents before processing the claim.

To prevent documentation errors gastroenterologists must educate their staff regarding documentation protocols. However, it will take considerable time, money, and effort. Alternatively, they can employ an outsourced GI billing company with proven experience.

The Bottom Line

All these above-mentioned billing errors significantly increase the revenue cycle of gastroenterology clinics. Moreover, it enhances their account receivables hindering cash flow. The best solution to address these billing errors is employing outsourced GI billing services. They will take over the wide-ranging administrative burdens of gastroenterology clinics, freeing up the in-house operational staff. Hence, gastroenterologists will get sufficient time to further improve their healthcare services and offer enhanced patient care.

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4 Steps to Choose the Best Outsourced Medical Billing Services

Medical billing is the process of recording and tracking all the financial transactions of the patient and then creating a bill for their medical procedures and diagnoses. However, there are several challenges in a billing operation such as billing inaccuracies, adherence to the updated billing regulations, and many more which eventually hinder the growth of healthcare providers. So that is why choosing the best outsourced medical billing services can be a feasible option for the providers to improve their cash flow.

What are the steps of choosing the best outsourced billing services?

Step #1: Check their experience and track record

Do you know what is the main reason for billing inaccuracies? Today there are many medical providers who have healthcare staff with not proper billing knowledge and end up facing complex nuances of billing process. So that is where you should check for those professionals who have years of experience in dealing with billing specialties. Moreover, their experts closely collaborate with the staff of the healthcare providers to make sure that the billing processes are accurate and also efficient.

Step #2: Check if they thoroughly comply with all the regulations

As the healthcare industry is regulated by constantly changing billing regulations, so that is why it is becoming difficult for healthcare providers to adhere to all the updated billing regulations. But the issue is if the providers focus on learning all the billing regulations, then they will not have the time to provide quality care to their patients which will hinder their growth. On the other hand, the best outsourced billing services stay updated with all the real-time regulatory changes, thereby leading to fewer billing errors and streamlining the claim process.

Step #3: They follow step-by-step prior authorization procedure

Prior authorization is difficult due to its complex rules and regulations which becomes challenging for the healthcare providers to manage. Apart from that, it takes a lot of time and effort to complete and track prior authorization requests, which increases their workload. Here, the outsourcing operational extension billing services manage the prior authorization process by navigating all the prior authorization protocols faster and efficiently.

Step #4: Dedicated Resources

As the staffs of the healthcare providers are involved in almost all healthcare operations, so they do not have enough time to particularly focus on billing operations, thereby increasing the billing errors. On the other hand, the medical billers provide dedicated resources who are specifically assigned to handle all the billing related tasks of the provider. Hence, it creates a streamlined billing process which leads to an increased cash flow.

Due to the ever-changing healthcare billing regulations, it is becoming difficult for providers to manage their billing issues. Moreover, if they focus only on improving their billing process, then they may not get the time to focus on quality patient care which will hinder their growth. So that is where the outsourced medical billing services can help to correct the billing error to make a quicker claim submission. So, if you plan to grow your business, you may consider outsourcing a billing company to improve your business.

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Specialty Pharmacy Billing Service: Prevent ROI Mistakes Easily

You handle many tasks as a specialty pharmacist. Handling your patient’s protected health information is a crucial part of your billing process. It includes records shared with patients, providers, or attorneys.

You always play a critical role in managing specialty pharmacy billing services and Release of Information (ROI). A single mistake in handling a patient's protected health information can be a costly affair for you. Your practice should strictly follow regulations under HIPAA. You need to understand exactly what information you need to share, with whom to share it, and the exact time limit. Your practice can face serious financial penalties if you fail to comply with these stringent regulations set by privacy rules.

Now, it is important to understand privacy rules so you can adhere to them properly.

Learn about the privacy rules

You must adhere to HIPAA privacy and security rules as these regulations are enforced by the U.S. Department of Health and Human Services Office for Civil Rights. These regulations require you to handle the protected health information of your patients very carefully. The Privacy Rule explains how your specialty pharmacy, as a covered entity, can use PHI. It also ensures patients understand their rights over their health data. Always remember that failing to follow any of these regulations can cause your medical practice to encounter heavy fines and reputational damage.

There are two types of penalties that you could face-civil or criminal. The type of penalty depends on the violation made by your side. You could encounter a fine of up to $25,000 per year if it is a mistake on your part. You can face criminal penalties if you have used patient information intentionally for profit or harm. These range from a $50,000 fine and one year in prison to $250,000 and up to 10 years behind bars.

You could face penalties if you do not follow PHI rules in your specialty pharmacy billing service. For example, if you do not release a patient's records within 15 days (about 2 weeks) or forget to include billing details, that is a violation. Even if it is a mistake, you are still responsible. Your penalty may add up for each missing date if you miss providing records for multiple service dates. Your penalty amount may go up to $25,000. Your patients can also file a complaint against you with the OCR (Office for Civil Rights) and it may lead to an investigation which can cause fines for your practice. The OCR tracks complaints, so repeat issues can bring more trouble.

If you share patient lists with a vendor for money or discounts, you could face criminal penalties. Even with a business associate agreement, you cannot use patient information this way without their permission. This is a serious violation and could lead to severe consequences.

Now, you might have realized one thing managing a specialty pharmacy billing service is not an easy affair as it involves stringent privacy rules to follow. A single mistake can lead to hefty fines and legal trouble. Fortunately, you can always stay compliant, reduce risk, and give your best to patient care with the right outsourcing partner. A professional billing company knows what it takes to streamline your end-to-end RCM service while enabling you to adhere to privacy laws properly. Let professionals handle billing and compliance, so you do not have to worry.

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How to partner with the right infusion billing company

Before choosing an infusion billing company, let’s know what infusion is - Infusion can be termed as a field of medication where medications are infused inside the bloodstream of the patient. It happens in a chronic situation or an emergency. That’s where infusion billing comes into the picture. But these types of billing have very strict coding guidelines which can be highly complex and also time-consuming. So, in this blog, all the problems that the infusion billing company can solve will be discussed.

Documentation Errors

It has been identified that there are various reasons for which documentation error occurs, one of the main reasons is failure in maintaining proper documentation. Hence, look for medical coders who are certified in infusion services, which eventually ensures optimum reimbursements and accurate coding. Apart from that, check also if their policy includes hierarchical coding, exact time of capture and multiple infusions.

Authorization requirements

One of the major issues in infusion services is that they are regulated with various changing rules. However, as these services require prior authorization mostly, that’s why the coordination between both the providers and also the payers gets lost. Eventually, the claims made are rejected. Hence, it can be suggested to choose a medical coder who has a higher approval rate because the quicker the approval, the less time it will take for prior authorization.

Payer Variability

The reason payer variability comes into the picture as a problem is that each payer has different reimbursement rules and policies for all infusion services. Hence, check for those service providers who have a vast amount of knowledge of contract-specific guidelines. Apart from that, they also face regulatory barriers related to CMS and commercial payers, and also drug shortage and fluctuations in price. So, check for those who can solve those also.

Denial management

As there are numerous coding issues, improper reporting of time and lack of documentation, that’s one of the key reasons for denials. That is why initially the medical coders identify the denial cause and then implement all the corrective actions, which significantly improves the cash flow of the healthcare providers. So, check for those who provide the most cost-effective outsourcing service which significantly reduces overhead costs.

Audit risks

Finally, the risk of the audit comes as all the infusion services get audited for compliance. However, if they don’t meet compliance, then all the providers face very stiff penalties. That’s why choose those services that provide a very detailed analysis and reporting which helps them to understand the healthcare providers’ revenue cycle.

As you can see infusion billing is a highly complicated and very time-consuming process that incorporates great detail and also regulatory knowledge which only the infusion billing company can solve. Hence, check for the RCM expert who can overcome all the challenges and also streamline their operations to provide high-quality care services.

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Assure growth with a dynamic health system billing company

It is true that your health system billing partner must understand how to handle everything for you right from patient registration to AR follow ups and managing of denials. Every claim that is handled by your outsourcing or in house team is directly going to impact your business revenue.

At these difficult times, it can be quite scary to find a reliable partner that can help everyone right from the beginning to the end. It will eventually come down to selecting a dedicated health system billing services company that offers tailored assistance to meet your revenue cycle management goals.

What you need is someone that understands your processes and delivers dedicated support. The health system billing company must allow you to focus on your patients and worry less about health care revenue cycle management. At the end, what you need is an immediate reduction of your overall operational costs.

Outsourcing to a competent partner to mitigate labor shortage troubles

Finding a serious partner to meet your daily health system billing requirements, creating a robust strategy to eliminate proven gaps is all about connecting the dots and optimizing your revenue potential.

Most of the challenges are also with health system prior authorization which leads to a lot of denials in the long run. At the end, you must be engaging with your audience a lot better and know how to work out a tangible solution by which you can work around with your payers in a cohesive manner.

Hence, it is imperative that you select a guide with complete knowledge of the latest guidelines in the world of health system RCM demands. Thus, opting for a dynamic partner to manage everything for you right from start to finish is going to be critical.

The Sun knowledge excellence

The biggest advantage of working with us is our extensive experience. What you need is a competitive partner that can allow you to focus more on patients and less on your collections. We help you address exactly that. Our team knows what it takes to deliver actionable support at next door rates that transform your collections in all possibilities.

Moreover, our versatility and exposure as a next gen RCM destination if top notch as we know what it takes to eliminate all your practice management worries. We are a complete health system billing and collections company and understand how to deliver according to your protocols. We have reduced pain points and operational expenses by almost 80% with our ability to work as a reliable operational extension.

Looking to know how we deliver true value! Our experts will be happy to share our ideas of a powerful business synergy with you, our client exclusive client references with you. What makes our story so prominent is our consistency and excellence. We can deliver you competitive health system billers and coders at these tight times with labor shortage and that too at just $7 per hour. Find what makes us a desirable health system billing services Company.

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Employing Concise Vision with Outsourced Medical Billing Services

Some of the recent details clearly illustrate that there are a lot of errors with submission of medical bills in spite of the latest developments with technology. Failing to use the right modifiers, overuse or implementing inappropriate details can be a huge hurdle for many.

Also, irregular reporting of the hydration codes especially with infusion which are time based are also key reasons for delay in your medical billing.

Finding resources that can help you in meeting your reimbursement demands are a genuine challenge for many.

Healthcare providers are in huge stress in knowing whom to work with and finding a balance with your revenue cycle management ecosystem.

The best ones have the knowledge on how to dive deep, engage in an appropriate manner to evolve daily practice management standards.

It is imperative that you select a guide that can drive growth, create best in class processes for a complete revamp in your revenue cycle management demands.

The right vendor can actually help in lowering your costs; combat the resource shortage challenge which is on every providers mind at present!

In fact, it is precisely the reason why outsourcing of medical billing services has actually become a pertinent solution for a lot of vendors.

It is appropriate to know whom to trust, make sure that the company is well versed with the latest claims adjudication demands and can actually help in bringing about complete transformation. That is where the difference is been made with a genuine outsourced medical billing services company.

Creating a hassle free action plan, implementing quality measures is all about choosing someone that can dive deep and engage with your payers in a professional manner. That will be making all the change and can actually bring about transparency in your healthcare revenue cycle management demands.

Resolving labor shortage with a quality outsourced medical billing services company

One of the major decisions that you must be ensuring is to find balance, choosing a guide with a serious understanding of the latest practices. But the most pressing aspect is to know how to initiate a genuine plan by which you can lower your operational costs significantly. Thus, it is imperative that you select a vendor that can determine your reimbursements in the ideal manner. That will be a make or break decision that you have to oblige.

Most of the decisions with a vendor are whether they have both on shore and off shore capabilities. That will be deciding how you should prepare in making things work out in the best possible manner.

A top class vendor with knowledge of the latest practices can define your growth and can actually help in elevating your cash flow concerns. You should be seeing more patients and get paid properly. Unfortunately, the scarcity of the resources creates a definitive change in the way you should be looking at your medical billing demands. Thus, it is imperative that you find a guide that can optimize your reimbursement efforts.

To conclude, it is extremely important to select someone consistent that can dive deep and optimize your ROI possibilities. Trusting the Sun Knowledge Inc’s expertise, you can lower your operational expenses once and for all. Speak to us and enrich your abilities as a reliable operational extension.

Get to know why we are hailed as one of the best in the business of outsourced medical billing and coding. Our team will love to give you a comprehensive idea on what sets us apart. Talk to us for a complete change in your revenue cycle management priorities.

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Tips to enhance your Gastroenterology Billing Services in Texas

Gastroenterology practices in Texas operate under challenging financial and operational constraints. However, in recent times changes in healthcare regulations, complex billing codes, and an increase in cost of operations created a scenario that requires an increasingly smooth revenue cycle. A newer factor that influences the financial strength of medical practice is the increasing minimum wages with states like Texas being part of the overall shift in the economic system.

Complexity in Gastroenterology Billing

It is true that gastroenterology billing has to deals with a vast array of procedures from colonoscopies and endoscopies to advanced treatments for conditions like Crohn's disease, ulcerative colitis etc. And each of these services has different billing codes, documentation requirements, and payer policies. Some common challenges in gastroenterology billing include:

Frequent Coding Updates: Incorrect or outdated codes may result in claim denials and delayed reimbursement.

Pre-authorization Challenges: Treatments are often delayed because procedures have prior approvals.

High Denial Rates: Documentation and coding make gastroenterology practices experience the highest claim denials.

Increased Administrative Burden: Labor costs rise, and so do regulatory requirements, stretching thin administrative resources.

The Effect of Rising Wages on Healthcare Billing

In the light of discussions concerning minimum wage hikes, including 21 states projected to increase wages in 2025, practices in Texas should be proactive to address cost implications. Higher wages will likely have an impact on the salaries of administrative staff and increase operational costs for billing and revenue cycle management.

The gastroenterology billing services outsourcing approach proves to be an economical method for practices looking to stay profitable despite these economic changes. Outsourcing to professional billing specialists will allow practices to keep their internal staff from getting too stretched in trying to ensure effective operations.

Benefits of hiring Gastroenterology Billing Services in Texas

There are numerous benefits for outsourcing the gastroenterology practices billing process to seasoned professionals, including the following

Accurate Coding and Documentation - Specialized billing firms hire qualified coders who are constantly updated regarding the latest codes of ICD-10, CPT, and HCPCS. This enables accurate claims submission and less denial.

Streamlined Pre-authorization Processes - Gastroenterology billing services resolve the need for pre-authorizations that do not delay treatment and enhance patient satisfaction.

Improved Revenue Cycle Management - These businesses optimize each stage in a revenue cycle, from claim submission to denial management and posting of payment, for quick reimbursements.

Cost Saved - With increasing minimum wages, outsourcing the billing process of the practice would be helpful to reduce overhead expenses such as salary, training, and technology expenditure related to an in-house team.

Patient Centric Care - Distributing billing responsibilities frees up administrative time to focus on high-quality care of patients by the gastroenterology practice.

Customized Solutions - A company that understands and adapts its services to fit the requirements of your practice would be an excellent choice.

It is no doubt that navigating the financial and operational challenges of gastroenterology practices in Texas requires a strategic approach. And as rising wages and regulatory changes continue to shape the healthcare landscape, partnering with a gastroenterology billing service can provide the expertise and efficiency needed to maintain a healthy revenue cycle.

By outsourcing billing processes, Gastroenterology practices can adapt to economic changes while focusing on their primary mission: delivering exceptional care to their patients.

The perfect billing partner to any Texas gastroenterology practice is not just a service but can be the key ally toward sustainable growth and success.

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The Dark Side of Infusion Billing: How One Mistake Could Set You Back

Infusion billing is not a piece of cake for everyone as you need to deal with various regulations associated with infusion, injection, and hydration services and procedures. You need to dot your i's and cross your t's to make sure insurance companies pay you on time.

That means checking the drug codes and billing units carefully. You also need to charge for the infusion services, pick the right CPT®/HCPCS codes, and throw in modifiers when needed. If you miss a step, it's like dropping the ball—so stay sharp and keep everything on track!

You must keep your documentation complete and super accurate if you want your infusion billing to run smoothly. It's no secret that infusion billing has a bunch of tricky spots where even the pros can mess up, especially if the administrative staff is new at it. You need to figure out where these common mistakes happen so you can avoid falling into the same trap. Stay ahead by learning from others' slip-ups, and you'll nail your infusion billing process like a champ!

Common infusion billing slip-ups that you need to avoid at any cost -

You can totally get your billing process running like a well-oiled machine by learning how an infusion billing company dodges common mistakes and makes sure you get paid on time. Starting with—

When you're billing for infusion and injection services, you should always put the infusion treatment first. This means infusion should be the main service listed. After that, if there are any injections or IV pushes, those should come next. Finally, hydration therapy should be last. This is the order a professional infusion billing partner follows to make sure everything is documented and billed correctly.

You can only use one initial code for each patient visit unless it's really necessary to treat the patient at two different IV sites. For example, if a patient gets treatment at one site and later in the day needs another treatment at a different IV site, you can use another initial code for that second visit. Make sure that you always use the correct modifier, like modifier 59 for Medicare, to show that the second treatment is separate and needed.

You give the medicine through an IV in 15 minutes or less during an IV push, and you need to stay with your patient the whole time to make sure they're okay. If the medicine takes 10 minutes or less, it's still an IV push. But if it takes more than 15 minutes, it's not a push anymore—it's an IV infusion.

Once you finish the first infusion, you can bill for sequential infusions if you're giving a different drug or service through the same IV access. But, there has to be a good medical reason to do it one after the other, not at the same time. For example, if you give one medication and then another through the same IV line, that's a sequential infusion. You can only bill for each one if you're using the same mix of medication.

Always remember one thing you cannot bill for hydration when you have given it at the same time as another infusion. You usually don't provide chemotherapy at the same time as other treatments but when you do so, you must use a special code.

You've probably noticed that handling the billing and coding for your infusion, injection, and hydration services is no easy task. But don't worry, you can avoid all the mistakes and make the process smoother by teaming up with an infusion billing company. A great infusion billing company makes sure your billing is accurate, compliant, and fast. The best part of working with a company like Sun Knowledge Inc. is that you can focus on giving your best care to patients, while they handle all your billing. You get to do what you do best, and they will take care of the rest!

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How to choose a decisive medical billing company

The rising patient wait times are in itself a huge challenge for healthcare providers. It shifts their process of focusing on patients and makes them more confused with their reimbursement objectives. Moreover, finding experienced resources to manage medical billing is becoming challenging with everyday a new vendor coming up and claiming in the digital space that they are the best! So the dilemma is even more than earlier!

But the question remains what should you look for in your medical billing company?

What will be the top priorities that you want them to address immediately?

Making sure that you have answers to all the following questions will be something that you should look forward for the right answers.

It is going to make you address both your patient care and improve on your bottom line with greater attention to details!

That is what is going to make it work out for you and assist you in gaining a definitive competitive advantage in the long run!

Also, it is going to be pertinent to find out what defines your credentials and help you make the most of your bottom line and create the right perspectives that can help in growing your reimbursements in the long run.

Today, physicians and patients shouldn’t be bogged down and worry if they are going to get paid or receive the treatment on time. That is going to be a huge advantage and will make sure that all your front and back end demands with RCM activities are in place.

Thus, it is pertinent for you to dive deep and know whom to trust in this space of medical billing service companies that are offering support at next door rates. A definitive partner with extensive knowledge on know-how’s of the industry will be able to deliver the right action plan and can help in lowering down your operational expenses.

How to select the ideal medical billing company

A pertinent question remains how will you be selecting your medical billing company? A genuine way to do that will be to know what their client references are across the industry. In fact, that will help you make a close assessment and come to know how to implement the right tactics for improved reimbursements.

Lowering down on your front end errors is the cornerstone of any medical billing activity. In fact documentation, charting, checking the eligibilities, working on authorization is going to set the benchmark for a lot of specialties.

It is going to improve the work done at the back end by setting the right claims submission process in place which will pave the stone for lesser denials and more collections. Not to ignore, quality medical coding has to be taken care off to avoid any wrong reflection of procedural or diagnosis details.

Achieve excellence with Sun Knowledge Inc

We are unique as we have extensive understanding on how to work on your ROI possibilities as a reliable extension. Our team knows what it takes to define your growth priorities and help you achieve a definitive competitive advantage. Speak to our experts and come to know how we set the benchmark in as a medical billing company. Our team is right here to assist you with any information you need!

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Amplify the Collection with A Perfect Healthcare Accounts Receivable Service

You probably know that doctors and practice managers still have to deal with a lot of money issues, and it’s really important to keep track of how you get paid, which is called the revenue cycle. One of the most important things to look at is the healthcare accounts receivable services metrics. It helps you understand if your practice is doing well with money or not!

Your A/R balance shows how much money patients or insurance companies still owe you for the work you've done. Tracking and collecting A/R is super important because no healthcare practice can keep going if it doesn’t get paid. But things like late payments, claim denials, and mistakes can make collecting A/R really tricky. The first thing you need to understand what A/R days are in healthcare accounts receivable services so that you can implement the perfect strategies to improve your overall collection and substantially reduce your overall A/R days.

Have a clear idea about A/R days in your healthcare practice

You need to know the average number of days your healthcare practice waits between sending bills or claims and getting paid by patients or insurance. The shorter this time, the quicker your payments come in, while a longer wait might point to delays that need attention.

You should aim to keep your A/R (the money owed to you) within 30 days—that’s the standard rule! If your practice has a big A/R balance, especially with amounts that are overdue by more than 90 days, it shows that collecting payments isn’t going as well. It’s super important to watch how much of your A/R has aged past 90 or even 120 days because it tells you if your practice is getting paid on time. If you let patients pay later for the provided services, you need to keep a close eye on these numbers to stay on track!

There are multiple reasons why your practice may encounter longer A/R days and some of the key reasons are-

Delays of making payments from payers’ sides

Frequent claim denials

Healthcare billing errors

However, one of the best medical accounts receivable outsourcing services enables you to implement the perfect AR management practices to ensure the best collection rate for your practices.

Let’s check out the effective strategies mentioned below –

Update your financial policies properly:

If it’s taking too long or feels harder to collect payments, it might be time to review your internal policies and the payment information you share with patients. Make sure your financial policy is clear about the steps your staff should follow when collecting overdue balances. It should also include instructions for documenting any promises patients make to pay their bills.

Make sure you update your patient documents so they’re clear on their responsibility to pay before or at the time of treatment. If patients have dental benefits and assign them to you, collect their share at the time of service. Once the benefit payments arrive, quickly send any remaining balance to the patient with a statement showing what’s due.

Adequate patient education:

Many patients aren’t fully aware of how dental payments from insurance work, which can make their financial responsibilities unclear. Providing a simple brochure or reference sheet that explains their role in the payment process can clear up a lot of confusion. It’s also helpful to have a knowledgeable staff member available to answer any questions patients might have about claims and payments.

Try to figure out days in AR for each payer:

You need to calculate the days in A/R for each payer individually. Knowing the average days in A/R across all payers and breaking it down by each specific payer gives you a clear picture. This approach helps you spot payers with longer-than-average A/R periods, so you can uncover any billing inefficiencies and take steps to speed up the payment process for those specific accounts.

File claims diligently:

When you delay claim submissions, your accounts receivable balance can quickly grow, as most insurance carriers have strict deadlines—often just days or weeks after treatment. Submitting claims after these deadlines often leads to routine denials. Using electronic claim submissions speeds up the payment process.

It is really important for you to manage your healthcare accounts receivable services in a pragmatic manner. You would be actually able to streamline a perfect AR management plan by partnering up with a professional medical accounts receivable outsourcing service. A perfect AR management company always enables you to drastically reduce overdue balance, avoid claim denials, and streamline the end-to-end revenue cycle management process.