Medical A/R - Be ProActive and Watch it Fall

Show me an Insurance Carrier or TPA that will pay or reverse an overdue claim simply because someone inquired about it, and I’ll show you an Insurance Carrier or TPA you'll be having payment issues with in the very near future, not to mention, that company more than likely will not exist in a couple of years or will have exited that line of business altogether.


Time and time again, whenever a medical accounts receivable report is generated and ofcourse some action is going to be required; the very first act is to print the report and hand it to a rep who grabs their list of payer phone numbers and starts dialing away. Although not totally worthless, all that calling without preparation wastes more time than it does producing results, which often leads to employee frustration. Working the A/R report is a dreaded task for most back office personnel and is a direct contributor to Employee “Lack of Motivation” to the project, or even worst “Turnover” when the employee has a chance to jump ship and leave their unresolved claims issues for someone else to figure out.

Being Proactive is the key to reducing the "overall" amount of the accounts receivable. Unfortunately, traditional A/R reps have 2 basic and natural instincts when it comes to collections:
1. Get the money in the door as fast as I can!
2.Whatever needs to be done or corrected, do it quickly so I can achieve objective #1.

However, neither does any good at reducing the overall A/R, reason being, as fast as the rep works to get a claim out of the A/R, another one or possibly more will take its place ensuring that the A/R will remain at a high level. Being proactive is the only solution.

I welcome your comments.