Accounts Receivable Follow-Up Management
AR Plus' practice is to perform a root analysis assessment to identify claims any errors. This method enables us to determine the best approach for getting claims paid in the most efficient and expeditious manner. During follow-up management, our focus is on all claims 30 days and older. We have been successful in assisting clients decrease their accounts receivable to less than 45 days. We provide our clients with monthly aging reports that identify claims status so they are aware of their financial position.
Claims Management
AR Plus can assist not only physicians with claims management services but also individuals. Our team is experienced in managing claims from the billing, coding and submission to completion. We develop strong rapport with healthcare agencies which enables our team to effectively get the claims paid. Our team can help you increase your bottom line while decreasing accounts receivable days.
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At times, it is necessary for individuals to bill insurance/healthcare agencies. Our team can advocate and ensure any out of pocket expenses are reimbursed. We understand the healthcare industry so they don't have to.
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Denial & Appeals Management
If claims are not compliant with the insurance policies, there is a possibility that they will be denied. At AR Plus, our team has had many years experience in the healthcare industry and is up to date on industry changes and guidelines. This advantage enables us to effectively manage denials. Our expertise in Healthcare Compliance also enables us to effectively assess denials and determine the modifications and/or documentation necessary to get the claims paid. If necessary, we will manage the denial through the appeals process. Our process also includes the tracking and trending of denial reasons. This enables our team to identify the areas of risk and to assist our clients in establishing internal procedures to reduce the number of claims that are denied.
Compliance and Auditing
It is the expectation of Healthcare regulators that medical practices are meeting compliance. The regulations are designed to control and prevent fraud, abuse and unethical activity. Many of these measures start the moment a patient comes into the office. Our team of compliance experts assist our clients with establishing internal processes and protocols that align with regulations. A large part of this work is the development or modifying of Policies and Procedures that establish levels of compliance.
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AR Plus will perform audits to identify risks and areas of non-compliance that result from coding and billing practices that do not meet industry standards. The audit results, if non-compliant, are addressed with established Corrective Action plans that monitor periodic levels of compliance. These efforts reduce the risks of costly fines and penalties. Compliance is vital for operational efficiency and although the goal is to maximize revenue, the standards of compliance must not be compromised. Our team can assist in being successful with both.
Post Billing and E&M Code audits
Bundled codes, upcoding, down coding and incorrect use of ICD-10 codes are some common issues found in medical billing. Billing and coding audits can identify these common errors. Establishing the correct coding method increases revenue and decreases loss of time, revenue and the possibility of being fined. AR PLus can perform an audit of a small sampling to ensure the correct codes are being utilized. The frequency of these audits is determined on a case by case basis. The goal is to audit frequently to capture those claims that can be re-billed within the allowed timeframe and also to address the error soon after it is identified.