Follow-Up, Don’t Fall Out!

Do you have a routine or system in place for following-up on claims?  Have you evaluated your time and efficiency on your follow-up processes?  Have you been looking for a way to save on labor and costs in your Accounts Receivable Department?  Keep reading!!

One of the most time consuming (and frustrating) activities in billing and collections is the follow-ups on claims. Most facilities will submit claims to multiple payers (Medicare, Medicaid, etc.) which means logging in and calling/emailing multiple plans in order to confirm the claim(s) status- AKA a hassle.[2]

In today’s post, we will provide a few tips to help you organize and manage your follow-up process through a routine approach.  A routine ensures no claim goes without being followed-up and that they are followed-up in the most efficient and correct manner.  Having a system for when follow-ups via emails, through online portals, and phone calls also makes the process exponentially more convenient.[1]

  A routine might include which day of the week/month you follow-up, how you initially conduct the follow-up (phone call, portal or email), time between follow-ups, your secondary follow-up method, and so on.  A routine will ensure claims do not get forgotten or swept under the rug.[3]

Step 1: Run/Print the AR report and compile your “Priority List”

Each patient management system (PMS) has its own version of the accounts Receivable (AR) report. This report details each outstanding account.  Most PMSs allow users to run reports by payer (or by resident) which will include a summary page. The summary page will help you identify trends with specific payers.  The full report will allow you to see which residents have the highest balance(s).

Once you have run your AR report, you will need to identify the oldest and largest balances. Another consideration to use is the payer’s timely filing guidelines.[3]

Most billers will either highlight or document these accounts on a separate file or system, which you should maintain each month.[2]

Step 2: Compare your Priority List with your notes

Now that you have your list, you need to review your previous notes.  As you review these notes, you should begin to identify the actions you are going to need to take to complete your next round of follow-ups. 

For example, we often break things down to include whether we will need to call, check a portal, or send an email. This process has helped REVEX billers save hours each day by allowing us to organize similarly related activities and addressing these items based on level of time and difficulty.  

Please schedule a meeting with REVEX if you do not already have a system to document your follow-ups or if you would like help in creating your file.

Step 3: Organize your Follow-Ups

After you have identified the next steps, you need to sort them by the type of follow-up and how much time you will need to complete each update.

In our experience:

Emails and the online portals are the easiest follow-up methods. Phone calls are the hardest (as they take more time).

If your follow-ups require making phone calls then schedule them in the early morning or late afternoon. This is when most customer service lines have fewer calls.

If your follow-ups require checking online or emailing a provider representative, then schedule them around your phone calls.[2]

Step 4: Timeline

85% of billers will follow-up at least weekly on the entirety their accounts.[2]

 We agree that claims need frequent follow-ups for claims to process timely. We also believe that the type of claim will dictate the frequency of these follow-ups!

For example, if a resident has two payers (ex. Medicare as primary and BCBS as secondary) then you will not need to follow-up with the secondary payer until after the primary payer has paid. What about documentation? You should still make notes on the secondary claims; however, a simple note such as “Pending Primary” until the primary pays will help ensure you spend your time wisely on these types of updates. Then, once the primary has paid, you can begin the next steps for the secondary claim.

For your follow-ups, we recommend following-up every 2-3 days on accounts that are approaching their payer’s timely filing guideline. This will help prevent write-offs for timely filing.

For all other accounts, you can schedule them for weekly updates. As payers confirm the claims are set to pay then begin to work on the next round of claims.

REVEX software and services work hard to automate steps 1-4 so your team can focus on step 5! 

Step 5: Execute

Now that you have put in all this hard work in organizing your information, you need to complete the most crucial step; execute your follow-ups!

You have put in all this hard work and you do not want it to go to waste. By having this plan, you can ensure you take each action. Additionally, by having your follow-up routine set you can adapt to your other responsibilities.[1]

Conclusion

The follow-up process does not need to be complicated. By breaking down each account into little (and easy) steps you can build momentum and get through your follow-ups.

If you or your billing team need help with what information you should record in your notes, or the actions you need to take in your follow-ups then please call or email REVEX to schedule a meeting. We would be happy to help you and your team overcome this obstacle and learn to operate as efficiently as possible with a customized plan! 

_________________________

Resources:
 
[1] Medical Billing Best Practices. (2016, October 18). Retrieved June 15, 2020, from https://clinicservice.com/best-practices-medical-billing/
[2] REVEX. (2020, June 1). Market Research Study.
[3] Why is A/R Follow-up Crucial in Medical Billing - FWS. (n.d.). Retrieved June 15, 2020, from https://www.flatworldsolutions.com/healthcare/articles/ar-follow-up-importance-medical-billing-process.php