Account Receiveable

Maintaining healthy revenue is essential for all medical practices. The largest impediment in path of healthy collections is pending account receivables or widely known as Aging in Medical Billing Industry. A poor claim submission process with limited checks will result in denials. These denials then if not addressed on an immediate basis will lead to revenue loss as most insurances have timely filing limit after a claim is rejected.

Account Receivables (A/R) plays a significant role in the financial wellbeing of the practices. As a general rule of thumb your practice aging i.e. pending claims for more than 120 days should be less than 3%. Some specialties like Anesthesia can have slightly higher aging but it should be not be more than 5% by any means.

Vigilant Medical Billing Services manage accounts receivables in a very unique way, our intelligence suite breaks down aging into each individual DOS month and create 5 segments showing. Claims which are 100% paid. Claims which are processed by Primary and are now pending at secondary or at patient’s end. Claims which are partially paid like some procedures are paid and some are denied. In Process Claims. Denied Claims.

Based on these categories claims are assigned to relevant teams, which take corrective measures by fixing the ICD DX and CPTs combinations, checking the insurance policy details, by sending medical documents as for certain procedures like Nerve blocks, A lines, C Lines, and multiple distinctive services. Most commercial insurances require medical records to establish the medical necessity for added procedures.

Patient Responsibility related to aging where patient needs to pay their copay, deductible or coinsurance require comprehensive follow up like sending automatic IVR balance reminders, E-statements, SMS balance reminders, phone calls, and lastly but not the least Patient statements. Vigilant Medical billing services has a dedicated bilingual (English & Spanish) patient engagement team which interact with patients to collect the balances over the phone or guide the patients to make it online.

In order to limit account receivables, it is vital to have an optimal mix of Coding Professionals, Experienced Billers, comprehensive audit practices, and effective procedures in place. Your medical billing staff/company should be equipped with qualified medical coders to correctly code the medical charts, experienced billers to correctly enter the patient demo and insurance information imbued with state of the art billing process to ensure that claims are properly scrubbed and highlight the potential risks and lastly a well-versed audit team which should review the whole billing before submitting.

VMBS mitigates your A/R rate by combination of experienced staff, best billing and coding practices and utilization of home-grown artificial intelligence auditing suite to successfully scrub the claims and highlight CPTs, Diagnosis and modifiers mismatches. Therefore, the aging rate of VMBS is less than 2%. Vigilant Medical Billing Services (VBMS) internally review A/R related KPIs with relevant teams and customers to ensure the better management of accounts receivables.

You outsourcing your aging or medical billing to Vigilant, you don’t need to worry about timely submissions, and pending accounts receivables. You will be surprised by the improvement, transparency and visibility vigilant will bring in your practice.