1. Determine if this is an external or internal issue. Review your aged accounts. I would recommend looking at your high dollar items in your 90-day bucket. Drill it down by payor and look at the account notes to identify any problem areas. Review your denial log and electronically transmitted claim reports as well to determine if this is internal or external related.
2. Evaluate business office processes to include staff skills. Collections are a coordinated effort that involves all business office staff. Evaluate your business office processes. Choose several days and review the step-by-step process from the beginning, starting with the verification process and follow through to billing, payor claim acceptance and reimbursement. This will identify gaps such as pre-collection issues, demographic issues during the claim scrubbing process and reimbursement issues once the payment has been received and the explanation of benefits has been reviewed for accurate payment. Payment posting accuracy and timeliness is important as well as switching guarantor responsibility at the correct time.
3. Prioritize accountants. Make sure that your staff is prioritizing which accounts they work first. There are many ways to prioritize your accounts. One method that works is:
- Work the high dollar accounts (over $1,000.00) in the 90-, 60- and 30-day buckets.
- Work the $999.00 and under in the 90-, 60- and 30-day buckets.
- Work the 120-day and over bucket, reviewing the high dollar items first.
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