AR Followup

AR Followup

We clearly understand account receivable is the vital part of any business. Our experienced billers use various follow-up methodologies to ensure prompt payment. We keep a good track of outstanding accounts and follow-up on time providing maximized revenues.

There are two types of claims Follow-Up:

  1. No Response Claims: Any claims in which absolutely no status is known for the claim.
  2. Unpaid claims: Any claims which remain unpaid for various reasons. These claims are routinely followed up on a monthly basis. The reasons includes:
  • Authorization Issues
  • Referral Issues
  • Medical Necessity and Medical Records requests
  • Non-Participation with Insurance Network
  • Terminated Insurance
  • Coordination of benefits
  • Wrong Diagnosis
  • Inclusive Procedures
  • Partial Payments
  • Out-of-network claim status and deductibles
  • EDI Rejections
  • Letter of Protection from Attorney cases
  • No status and No claim on File
  • Workers' Compensation
  • PIP cases

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.

Apart from normal follow up, we implement a unique strategy plan for follow up claims based on priority:

Priority 1 - High Dollar High Age - These claims would be processed on priority as the claims need to be followed up before we exceed the filing limit.

Priority 2 - High dollar Low Age - Next focus would be on high dollar claims with low age as the chances of collection are higher.

Priority 3 - Low Dollar Low Age - These claims have higher probability of collection. However, need many more resources to follow-up.

Priority 4 - Low dollar High Age - These claims are given last priority as these claims have less chances of collection and need high number of resources to follow-up.

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