Work from home: Eliminate touches

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Thursday, July 9, 2020

Q. How can I ensure my team is working efficiently?

A. After providers analyze their data and determine that the work is getting done, the next piece of the puzzle is to determine how effective the team is while working the claims. This is critical to the profitability of a business, since every time a team member interacts with an invoice or fights with an insurance company, there is an associated cost. The bottom line is that every time a provider eliminates the need for a human to interact with a claim, they are becoming more profitable.

Providers should start with a trended view of the accounts receivable (AR) and focus on the aging. By looking at the historic data, providers can get a baseline, bucket by bucket, and focus on anything that is out of tolerance. For example, determine what percentage of the AR is historically in the 0-30-, 31-60-, 61-90-day buckets and so on. Now you can easily see if the buckets are staying in tolerance and start to dig deeper as you identify issues.

Another quick fix would be to analyze the claims in the initial setup and identify preventable errors. Modifiers, narratives, date spans and a lack of eligibility checks are the usual offenders.

The main goal is to eliminate touches and keep claims from aging past 90 days. Once a claim ages past 90 days, the average collection rate is 30% to 40%. Use the data mined in the 31-90-day bucket to identify process improvements upstream to get the cash in the door faster and eliminate write-offs.

John Stalnaker is vice president of sales at ACU-Serve Corp. Reach him at jstalnaker@acusesrvecorp.com.