Optimizing Accounts Receivables for a US-Based Healthcare Revenue Cycle Management Company

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Enhancing Revenue Cycle Management: Overcoming AR Issues and Cutting Claim Denials

Client and Requirement:

  • Client: prominent healthcare revenue cycle management company in the US, specializing in optimizing financial operations for healthcare providers.
  • Requirement: The client needed effective handling and maintenance of their Accounts Receivables (AR) processes, particularly focusing on managing aged accounts and reducing claim denials..

Key Challenges:

    1. Aged Accounts: Managing accounts in the 60, 90, 120, and 180-day aging buckets.
    2. Partial Payments and Denials: High percentage of non-payments due to:
      • Timely Filing: Claims not filed within the required time frame.
      • Pre-Authorization: Lack of necessary pre-authorizations.
      • Billing Errors: Incorrect demographics, billing errors, and incorrect codes leading to claim rejections.

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