Claims tracking teams in healthcare organizations are responsible for handling denied claims and reopening them for maximum reimbursement from the insurance company. Medical A/R billing and revenue management managed by an in-house team are outdated. Currently, billing experts with specific skills are needed to handle A/R tracking services.

It should be noted that apart from the A/R cleaning service, there are several other important processes such as clearing, verification, and payment order that must be completed first.

There is a possibility that the insurance company will reject the claim if it does not follow the rules. Therefore, it is important to have a dedicated A/R team and insurance tracking specialists who can track down the insurance company to resolve your waiver. You can also consult experts for qualified nursing home collection solutions.

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Most medical billing specialists perform A/R tracking in a very systematic way, which usually takes place in three steps:

Evaluation

In this step, the damage events listed in the A/R aging report are identified and analyzed. The team reviews supplier policies and determines which claims need to be remedied.

Analysis and Priorities

This phase begins after identifying receivables that are marked as bad or that have not been paid by the operator according to the rates agreed with the health care provider.

Collection

Claims that fall within carrier submission limits will be processed after verification of all required billing information, such as an address for processing claims and compliance with other medical billing rules. 

Once done posting the payment data for the unpaid account, the patient account is created according to the client's instructions and then tracked with the patient for the payment.