Accounts Receivable Services

Accounts receivable, which are often times simply called AR, are the money that is owed to the company by customers for goods sold or services rendered.It includes Patient Account transcation and Receivable Management.

SIDSOFT Healthcare Accounts Receivable Services

By shortening the "days in healthcare accounts receivable" cycle, SIDSOFT is able to help improve your cash flow and reduce claims denials, thus turning healthcare accounts receivables into cash.

SIDSOFT can help with AR calling, following up pending claims, initiating collections, tracing the reasons for claims denials, tracking outstanding receivable balances by customer and by the date when payment is due, providing periodic reports and more.

SIDSOFT AAPC-certified medical coders know the ins and outs of both diagnostic coding and procedural coding. We code for surgery, lab and other tests based on the guidelines of AMA and CMS.

SIDSOFT claims, delayed collections place added administrative strain on a hospital or physician's practice. On one hand, insurance companies often deny claims or refuse to pay them. On the other hand, federal regulations have become increasingly more stringent in the USA. Recently the federal Centers for Medicare & Medicaid Services announced that they would reduce the time physicians are given to file an appeal against a claim denial - from six months to 120 days. This increases the pressure on the staff at your healthcare practice to follow up on denied or appealed claims.

If your healthcare practice has healthcare accounts receivables, this means it has delivered a service but has yet to collect the money from the purchaser.

Why do I have to face so many claims denials?

We will use Medicare as an example but this could apply to Medicaid or other third party insurance companies as well.

Medicare claims get denied mainly for the following reasons.

  • Incorrect or missing ICD-9 diagnoses
  • Incorrect or missing CPT-4 modifiers
  • Duplicate claim
  • Additional information needed to process the claim
  • Claim billed amount incorrect
  • Incorrect or missing CPT procedure code
  • Physician's name and/or UPIN missing or incorrect
  • Incorrect or missing place of service code
  • Incorrect or missing quantity of services (Service billed without "quantity" noted, or with multiple quantities indicated in error on claim)
  • Services inappropriately bundled

As you can see, some of the main reasons for claims denials are incorrect/incomplete data entry and incorrect medical coding.

How can I avoid payment delays for healthcare claims?

SIDSOFT helps you avoid payment delays from Medicare as well as from other third-party insurance payers by following these steps:

  • We review all claims before submission This cuts down significantly on the error rate. We spend time on reviews at the front end, rather than spend a longer time later to deal with each denial.
  • We maintain a billing and coding claims review log We track the trends for each healthcare BPO provider, based on the remittance advice from Medicare as well as the EOBs (Explanations of Benefits) from all third-party payers. We monitor and evaluate these trends to find ways to fix the problems causing the denials and rejections for your practice.
  • We do a monthly billing review All the staff involved in the accounts receivable function, ie: those who perform tasks such as data entry, coding and documentation, billing and payment posting analyzing denials and down codings get together once a month to review:
  • All recent insurance carrier newsletters and notices of any billing or coding changes
  • Current practice issues that are relevant to the billing function, and
  • An analysis of the trends noted from the "claims review log," including how these trends are being handled and the effect on the accounts receivable, measured both in terms of the percentage of error and as "dollars and cents."

If you want to ensure that you get paid promptly and in full for each healthcare claim, and actually increase your revenue by up to 20%, your healthcare accounts receivables department to SIDSOFT.

SIDSOFT Medical Claims Processing to India

Do you require high quality, customized medical claims processing services? Why not consider SIDSOFT to India? Read more specific information about SIDSOFT Healthcare infrastructure.Discover more about SIDSOFT clinical services