Case Study on Accounts Receivable Services

The Customer

The client is a renowned healthcare organization in the industry. They have an internal team which operates with clearinghouses and insurances companies to send claims and review the acceptance reports and detect any kind of submission mistakes. Any kind of registration issues are solved within 24 hours by the team and the errors are measured based on a percentage. This data along with the other reports are shared with hospitals on a regular basis. They also undertake any kind of edit which is needed in the software and trigger any kind of warning.

Before any kind of call is made to the insurance company, it is important that a complete analysis is undertaken of the inventory and the priority plan is shared with the customer. The client's priority list consists of old AR based on collectible and non-collectible denials, followed by high dollars in descending order, and finally new AR and non-collectible denials. The pattern of denials is identified when each of the priorities is presented in the form of a report which is shared with the clients on a monthly basis.

Accounts receivable is one of the most important steps in the revenue cycle management process. It helps organizations to maintain a better cash flow and collect the outstanding AR. Some of the problems faced by the client are listed here -

• The claim denials were handled without any kind of analysis
• There were no preventive measures taken by them
• They did not have the means to have proper documentation or escalation done

Challenges Faced by Us

There were a few challenges we faced when the client decided to outsource their AR requirements to us. They were -

• The AR would get difficult to handle at times as majority of the AR volumes would accumulate in the old AR
• It was getting difficult to follow-up with insurance as there was no proper escalation or documentation done for these claims
• The claims were running into timely filing limits, in spite of the client knowing how to handle the claims and what actions need to be taken to resolve them

Our Answer to the Problems

Taking into consideration the entire client's problems and keeping in mind the challenges we had to face, the following solution was planned for the client -

• It was decided that the various patterns and trends would be identified to help us collect the money in case of bulk denials
• The AR would be separated based on the age bucket, as it would help us to arrange the priority of the AR based on its severity
• A proper training program would be held for documentation and escalation. This would be helpful in understanding the consecutive follow-ups and correcting any kind of errors if any

The Results Achieved

The team at Outsource2india ensured that the entire process went according to the plan. It was our priority to provide the required services within a quick turnaround time. Some of the key results we achieved during this project were -

• The claim denials can now be conveniently categorized and the edits can be added to stop most of the denials before entering the charges and at the front-end
• Instructions can now be prepared and kept securely for future references and avoid any kind of unnecessary appeals or follow-ups
• The most important achievement was that we were able to help the client to improve their cash flow and follow a healthy working style henceforth

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Outsource Healthcare Accounts Receivable Services to Us

Outsource2india has been providing quality accounts receivable services to global clients along with other healthcare BPO services. Outstanding claims and delayed collections can prove to be strenuous to any organization, and we are here to help you out to relieve this strain. Our team is trained to handle any kind of AR requests and also is always updated with the latest rules and regulation changes in the industry. Our cost-effective services help you efficiently manage the incoming funds and hence maintain a good cash flow.

If you are looking for a reliable, safe, efficient, and cost-effective accounts receivable service provider, then you have come to the right place. Get in touch with us today!