If you haven’t done so already, employ the help of your biller, billing company or a seasoned administrative staff member to clean up both insurance and patient aging. Start with insurance aging to ensure patient balances are correct before attempting to collect one last time this year. Begin by running two separate reports. In both cases (insurance and patient), it is ideal to see 15% or less of total aging in the 91-120 day bucket (or worse case in the 121+ day/oldest bucket). Anything older than that is often uncollectable. Look for OLD, ROUND numbers within Insurance Aging reports (this usually means the entire claim or certain line items were not paid; often seen with surgeries, DME, and payers who will only reimburse for one procedure per visit, YIKES!). Then, ask yourself. . .

• Who is watching this and what is the reason that these claims or line items are not being paid (or even responded to by payers)?
• Are we continuing to bill for codes that are not on our fee schedules?
• How much money are we leaving on the table because of timely filing; claims sitting in user hold, and rejected claims that are not being “worked” to find out how to correct and resubmit?
• Stay tuned for next week’s Pro Tip (Lower Rejection Rates)

After you have determined which outstanding insurance balances are actually patient
responsibility. . .
If the balance is greater than 120 days old and less than $10, “write it off” but set an alert for the next time the patient comes in or attempts to make an appointment to collect it. Don’t send statements for less than $10. Decide if you want to keep looking at the same names (patients who were seen as hospital consults or in outside facilities, didn’t have insurance or were “pending Medicaid”) or if you want to “kiss it good bye” (often the same as turning them over to collection agencies).

Or. . . and, I highly recommend this one. . . Give it one last attempt!

• During a day (or part of a day) that you are in surgery (or do not have clinic patients scheduled), have a staff member (the best “schmoozer”) call patients with balances.
• First, checking with the patient to make sure we have the correct mailing address as several statements have been sent with no response (giving the benefit of the doubt that patients aren’t ignoring statements).
•  If the address is verified or corrected, the patient is then provided the opportunity to pay their balance via credit card over the phone.
• For larger balances you can have the staff member offer a professional courtesy (discount) in order to keep the patient out of collections (discuss this ahead of time as something is better than nothing).
• If the patient states that they will promptly mail a check, the staff member makes a note in the chart and thanks the patient for payment in advance.

Cleaning up A/R as much as possible by year’s end and prior to “deductible season” starting over is a great way to kick off the new year on the “right foot.”