Caresync Medical Billing prioritizes Accounts Receivable Management (ARM) as a cornerstone of its service offerings.By ensuring timely payments from patients and insurance companies while minimizing bad debt risk, ARM is instrumental in optimizing cash flow and reducing the impact of bad debt on operations. Caresync Medical Billing excels in consistent follow-up, analyzing aging reports, proactive collections, maximizing insurance claims, and empowering patients with financial information. This comprehensive approach to ARM positions Caresync Medical Billing as a trusted partner in optimizing the financial health of healthcare providers

Introduction

This Standard Operating Procedure (SOP) outlines the step-by-step process for managing accounts receivable at CareSync Medical Billing. Effective accounts receivable management is crucial to ensure timely payment collection and optimize cash flow.

1. Patient Insurance Verification:

– Pre-Service Verification: Verify patient insurance coverage before services are provided.
– Accuracy: Ensure the accuracy of insurance information, including policy numbers, group numbers, and effective dates.
– Eligibility: Confirm patient eligibility for the requested services.

2. Claim Submission:

– Timely Submission: Submit claims to payers within the required timeframe.
– Accuracy: Ensure the accuracy of claim information, including patient demographics, diagnosis codes, procedure codes, and modifiers.
– Electronic or Paper: Submit claims electronically or by paper, as required by the payer.

3. Payment Posting:

– Prompt Posting: Post payments promptly upon receipt.
– Accuracy: Verify the accuracy of payment information, including amounts, dates, and references.
– Adjustments: Apply any necessary adjustments, such as refunds or credits.

4. Denial Management:

– Review Denials: Promptly review all claim denials.
– Appeal: Appeal denials that are deemed unjustified.
– Resubmissions: Resubmit claims with corrected information or additional documentation.

5. Aging Report Analysis:

– Regular Analysis: Generate and analyze aging reports weekly or monthly.
– Identify Delinquencies: Identify past due accounts.
– Prioritize Collections: Prioritize collection efforts based on the age of the account.

6. Patient Billing:

– Patient Responsibility: Send patient bills for any amounts not covered by insurance.
– Payment Options: Offer various payment options, such as credit cards, checks, or financing plans.
– Follow-Up: Follow up with patients who have outstanding balances.

7. Collection Efforts:

– Initial Contact: Contact patients with past due balances to remind them of the outstanding amount.
– Escalation: Escalate collection efforts as necessary, including sending collection letters or contacting collection agencies.
– Payment Plans: Offer payment plans to patients who are unable to pay the full amount.

8. Bad Debt Write-Off:

– Criteria: Establish criteria for writing off bad debts.
– Documentation: Document the reasons for writing off bad debts.

9. Reporting and Analysis:

– Monthly Reports: Generate monthly reports on accounts receivable, including aging analysis and collection efforts.
– Trend Analysis: Analyze trends in accounts receivable to identify areas for improvement.
– Benchmarking: Compare performance to industry benchmarks.

10. Compliance:

– Regulations: Ensure compliance with all relevant federal and state regulations.
– Payer Contracts: Adhere to payer contracts and guidelines.