Use Real-time Data Analysis to Identify the Gaps in Hospital AR
Providers often face challenges with minimizing rejected claims, improving cash flow and reducing accounts receivable delays. All they need is to streamline the accurate collection of patient insurance and eligibility information. Implementing regulations such as ICD9-10, Accountable Care, Bundle Payments and Meaningful Use will initially add to these challenges. The resulting changes can potentially cause loss of accounts receivable (AR) at point of service. Along with quality of care, AR is one of the key areas which hospitals work towards improving continuously.
To resolve issues associated with AR, it is important to identify the various touch points that can be cause bottlenecks in claim processing, thereby in AR.
To guard against hold ups from patient admission to claim settlement, let’s see the five common reasons for AR delays prior to claim submission:
Possible cause of delay
|Hospital Information Management (HIM)|
|Billing and Claim Submission|
Payers have certain mandates, failing to meet which can cause delays post claim submission, the most common ones being:
|Type of delay||Reason|
|Claim put on hold due to additional information required|
|Bad Debt||Payment not received from Patient|
Obviously, some of these issues are caused by human error and cannot be solved easily. One solution could be real-time tracking of key elements related to AR from patient’s admission to discharge.
Harish C. Rijhwani is a Delivery Manager at Syntel with 14+ years of experience in Healthcare across multiple technologies and domain.