Accounts
Receivable

Accounts Receivable Follow-Up and Denial Management Services

Accelerate claim recovery and strengthen your cash flow. 

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Industry averages suggest a staggering 20% of all claims are denied, and 60% are never reworked. Whether claim errors happen during the front-end, middle, or back-end stages of the revenue cycle, denials can almost always be prevented and reworked. Partnering with accounts receivable (A/R) and denial management professionals is your best defense to recover your hard-earned revenue and implement systems to improve clean claim rates.

Outsourcing accounts receivable follow-up and denial management to Global Healthcare Resource streamlines this process. Our experienced A/R follow-up teams help maximize recovery efforts by organizing denied claims by timely filing and dollar amounts. Once the most urgent claims are determined, our teams research the issues and work with insurance companies to refile and collect as many claims as possible.

If you need assistance collecting payments from patients, our courteous patient contact specialists can help. Our highly trained specialists call patients from our secure call centers to educate them about their remaining balances, discuss potential payment plans, and collect payments.

With over 25 years in the industry, we have refined the medical billing A/R follow-up process to ensure optimal reimbursement. Our experts follow a tried and tested approach that reduces days in A/R to meet or exceed industry benchmarks. 

Accounts Receivable Auditing Services for Medical Billing

Global's A/R teams run regular audits to identify troublesome patterns within your reimbursement cycle. Our thorough reporting and analysis of your front-end, middle, and back-end processes will provide a wealth of insight so your organization can make the most informed adjustments. Global strives to make an immediate impact while helping your organization lay the foundation for a healthier revenue cycle in the long term. 

To improve internal systems and increase claim-to-reimbursement times, we frequently conduct a thorough audit of your medical billing accounts receivable procedures, including:

• Insurance claim accuracy and submissions
• Claim resubmission procedures
• Compliance with coding guidelines
• Coding accuracy
• Automated charge posting

Outsourced A/R Denial Management Services

Streamlining your claim denial process and reducing your overall denial rate ensures you receive reimbursement sooner and improves your business's cash flow. Our professional denial management approach encompasses these essential steps:

• Evaluate denial types and frequency to identify common denial trends
• Investigate the reason for each denial, including data and coding accuracy, policy coverage, and delayed submissions
• Divide received denials into categories to establish solutions to combat denial rates per category
• Correct claim errors and resubmit them for payment
• Monitor the success of resubmitted claims and adjust strategies accordingly

We customize our denial management services based on your project's needs. To explore our team's capabilities, learn more about the specific denial management services we offer below. 

Medical Billing Denial Management

Claim errors can occur at any stage during the revenue cycle. Some of the most common causes for denials include: 

• Claims that contain inaccurate or omitted patient data
• Submitting a claim after the filing deadline
• Coding-related errors
• Claiming for a procedure that the insurer did not authorize 
• Sending in the same claim two or more times
• Conflicting patient coverage where more than one type of insurance exists

Almost all denials are preventative and often occur during the front-end of the revenue cycle. Utilizing effective and focused automation systems for scheduling, eligibility verification, prior authorization, and patient demographics will significantly reduce errors.

Outsourcing patient eligibility verification, medical billing, A/R follow-up, and denial management tasks to a trained team improves your operation's efficiency and reduces your claim denial rate.

Coding Denial Management Services

The Global Healthcare Resource denial management team contains highly skilled medical coders committed to auditing claims for coding-related errors, resubmitting them once corrected, and developing preventive strategies based on your organization's denial trends. Our process includes: 

• Evaluating documentation related to the procedure, test, or consultation
• Noting the medical codes stipulated
• Establishing the correct codes in line with ICD-10, DRG, HCPCS, and CPT regulations
• Adjusting the claim to reflect the correct medical codes
• Resubmitting the amended claim

Medical codes assigned by our team undergo strict internal and external auditing processes to ensure we maintain our 98% accuracy rate.

Telemedicine 

In terms of telehealth, A/R follow-up is more important than ever. Digital care visits have provided an excellent solution for busy patients. However, guidelines around telehealth reimbursement can be challenging, creating more denials that need to be reworked. Avoid further strains on your cash flow by working with a well-versed staff on the common billing issues associated with telemedicine. 

Benefits of Outsourcing Accounts Receivable

When you outsource your accounts receivable management to Global Healthcare Resource, you expand your capabilities through a reputable service performed by talented individuals. Our team operates as an extension of yours, affording you several benefits:

• Reduced claim errors: With a medical billing and coding team dedicated to A/R follow-up and denial management, we will enhance claim accuracy and reduce denial rates.
• Quicker claim payments: You receive reimbursement sooner due to minimized claim errors and efficient denial management delivered by our A/R management services. We determine the cause of the denial, correct the claim where applicable, and submit an appeal, helping you reclaim more of your hard-earned revenue.
• Lower department expenses: Partnering with our 6,000-plus skilled and HIPAA-compliant team members is more cost-effective than recruiting, hiring, and training in-house A/R follow-up employees.
• Enhanced patient satisfaction: Patients will feel more at ease with our highly trained and courteous A/R engagement specialists conducting medical billing follow-up calls. In addition, the reduction in claim denials will pose less of a burden on patients, ensuring they enjoy a better service experience.
• Advanced coding systems: Our accomplished coding team ensures better coding accuracy and compliance, improving clean claim rates for timely reimbursement. 

Your Trusted RCM Company for A/R and Denial Management

Global Healthcare Resource leverages our immense industry experience to deliver the best A/R management services. We foster a partnership approach with every client, ensuring your organization's success is our priority. 

Our Global Academy-trained team spans the U.S., the Philippines, and India, giving you access to 24-hour service delivery. We never use subcontractors, so you can rest assured your Global Healthcare Resource team members have the knowledge, expertise, and commitment to help your business succeed.

Reach out to us today to find out more about our A/R follow-up and denial management services.