As the end of the year approaches and deductible season looms, there will be a fury of special projects to mine cash from outstanding accounts receivable. Unfortunately, we are sure to find balances that are uncollectible because the allowed time limit for filing claims has expired. It is frustrating, but remember:
Timely filing denials are a symptom; they are not the cause of uncollectible accounts.
Causes are things that give rise...that yield a result or effect. To be sure, sitting unresolved for too long is not good, but what caused the claim to sit unattended?
Timely filing denials are a symptom; they are not the cause of uncollectible accounts.
Causes are things that give rise...that yield a result or effect. To be sure, sitting unresolved for too long is not good, but what caused the claim to sit unattended?
Causes might include:
- Missing or incomplete documentation at intake
- Incorrect modifiers due to staff training or software user errors
- Missing policy information
- Deficient processes for ensuring continued patient compliance
- Unaccountable denial management processes (emphasis on process, not people)
- Develop specific processes to ensure the proper documentation is obtained during the intake process and transmitted properly with claims the first time
- Educate staff and utilize quality control tools to ensure proper modifiers are used
- Develop strong analytical practices that identify recurring problems and reverse engineer solutions
- Enter all denials into the billing database as part of payment posting for prioritized attention, transparency, and accountability
- Monitor and measure successes consistently
Treating the symptom, on the other hand, by correcting errors after the fact results in a massive amount of labor, while the next round of claims remains stuck for the exact same reasons. Frustration and anger over timely filing are wasted emotions. They do not reduce recurrence. Instead, look to understand and remedy the underlying cause to get better results with less effort.
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