Accounts Receivable Management

Comprehending Accounts Receivable (A/R) is one of the most important process in the revenue cycle of a medical practice.  It pays for your salary, your office and your bills.  Failing to adequately work denials from insurers translates to loss of revenue for your medical practice.

At Star ITech, we provide a range of accounts receivable services to our clients with an option to outsource all or part of your accounts receivable backlog to us and benefit from high-quality services at a low cost.  Star ITech leverages a large workforce of highly trained Accounts Receivable associates who manage your accounts receivable efficiently and save your time and money.  Our medical Management team classifies denials by reason, source, cause and other distinguishing factors.  We develop and assess effective medical management strategies.

At Star ITech, we understand Accounts Receivable for a medical clinic.  We generate an insurance aging report and track outstanding claims every week by paying attention to the clearing house status report.  We analyze information obtained from financial statements using basic financial ratios specifically looking for words like “zero payment,” “rejected,” “holding claim” or “unprocessed.”

While denied claims are a chief source of frustration for your billing staff, they also put a pressure on your practice’s cash flow.  By proactively striving to Identify, Monitor, Manage and Prevent denials, we at Star ITech educate your employees, streamline your work, improve your internal processes and make sure you get paid what you deserve.

For the long-term success of the Revenue Cycle, establishing an effective denial prevention program is crucial.  We have the required infrastructure, resources, expertise and experience to provide better results and our approach ensures that our services are delivered on time at cost-effective rates.

Our A/R management service is designed to increase Revenue Collection and reduce operating expenses. The process begins after the clients office creates and sends the Insurance Claims (Electronic/ Paper claims) to the respective carrier.

Depending on the transmission type and length of time since submission we begin our follow-up:
  • Electronic Claims – Follow-Up begins 10+ days after submission
  • Paper Claims – Follow-Up begins 20-45 days after submission.

There are two types of claims Follow-Up:

  1. No remark claims: Any claims in which absolutely no status is known for the claim.
  2. Last remark claims: Any claims which remain unpaid for various reasons. These claims are routinely followed up on a monthly basis. Some of the reasons for rejections include:
    • Authorization Issues
    • Referral Issues
    • Narrative required
    • Non-Participation with Insurance
    • Terminated Insurance
    • Non co-ordination of benefits
    • Incorrect coding
    • Inclusive procedures / bundled payments
    • Partial payments
    • Out-of-network claim status
    • No claim on file

The Follow-Up process is divided into 3 methods:

  1. Online Claims Follow-Up – Using various Insurance company websites and internet payer portals we check on the status of outstanding claims.
  2. Automated Claims Follow-Up (IVR) – By calling Insurance companies directly an Interactive Voice response system will give the status of unpaid claims.
  3. Insurance Company Representative – If necessary calling a “live” Insurance company representative will give us a more detailed reason for claim denials when such information is not available from either websites or Automated phone systems.

Once the Follow-Up process has begun Denied Insurance claims will require extra effort for resolution.Denials management is divided into two categories:

  1. Claim Correction and Re-submission – These are the claims which are corrected, modified, and resubmitted as a corrected claim to Insurance companies. For such claims every effort is made to resolve the denial to avoid billing the Patient.
  2. Patients’ Responsibility – These are claims which cannot be further worked upon and the final bill is sent to the patient for payment collection. In such cases, the client’s office is informed and further action is taken by the office staff.

Our AR management solution allows practices to manage their ever-growing number of insurance claims because we proffer the service and expertise needed to effectively handle all aspects of the accounts receivable department.

Ineffective management of your insurance accounts receivable can be detrimental to the profitability of your practice and cost your organization a substantial amount of money. This is typically caused by a lack of time or unorganized and unproductive efforts by the in-office staff. Our service alleviates this concern by always following industry best practices and operating with the utmost efficiency. This is the result of a combination of our skilled and knowledgeable subject matter experts and our array of innovative management methodologies.

  1. Increased cash flow
  2. Increased practice profitability
  3. A decrease in days in accounts receivables
  4. A decrease in the overall percent of accounts receivable over 90 days of age
  5. A decrease in the dollars released to bad debt write off
  6. A more manageable claim load per collector
  7. An improved patient / healthcare provider relationship
  8. A sharp reduction in losses due to missed filing and/or appeal deadline
  9. An income statement benefit from 3-10 times our fee