AR follow up, Accounts Receivable, Claims follow up, Outstanding Claims

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Clinic Spectrum - Medical Transcription Services, Accounts Receivable Follow-ups, Scanning & Indexing, No-Show Rescheduling & Appointment Scheduling, Eligibility Verification with Payers, Referral Submission & Tracking, Payment Posting, Demographics & Claim Entry, Credentialing, NJ, New Jersey, New York, USA.
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Accounts Receivable Follow Up

ACCOUNTS RECEIVABLE FOLLOW-UP

$6.5 per hour* onwards or $2.25 per follow-up based on workflow plan


Our A/R Follow Upservice is designed to increase Revenue Collection for Physician offices.  The process begins after the Doctor’s biller creates and sends Health Insurance Claims (Electronic/ Paper claims or Manual HCFA forms) to various Insurance companies.  Depending on the transmission type and length of time since submission we begin our follow-up:

 

Electronic Claims:  Follow-Up begins 10+ days after submission

 

Paper/HCFA Claims:   Follow-Up begins 20-45 days after submission

There are two types of claims Follow-Up:

  1. No remark claims: Any claims in which absolutely no status is known for the claim.

  2. Last remark claims: Any claims which remain unpaid for various reasons. These claims are routinely followed up on a monthly basis. The reasons for rejections include:

    • Authorization Issues
    • Referral Issues
    • Medical Necessity and Medical Records requests
    • Non-Participation with Insurance Network
    • Terminated Insurance
    • Coordination of benefits
    • Wrong Diagnosis
    • Inclusive Procedures
    • Partial Payments
    • Out-of-network claim status and deductibles
    • EDI Rejections
    • Letter of Protection from Attorney cases
    • No status and No claim on File
    • Workers' Compensation
    • PIP cases

    The Follow-Up process is divided into 3 methods:

    1. Online Claims Follow-Up – Using various Insurance company websites and internet payer portals we check on the status of outstanding claims.

    2. Automated Claims Follow-Up (IVR) – By calling Insurance companies directly an Interactive Voice response system will give the status of unpaid claims.

    3. Insurance Company Representative – If necessary calling a "live" Insurance company representative will give us a more detailed reason for claim denials when such information is not available from either websites or Automated phone systems.
    Once the Follow-Up process has begun Denied Insurance claims will require extra effort for resolution. Denials management is divided into two categories:

    1. Claim Correction and Resubmission: These are the claims which are corrected, modified, and resubmitted as a corrected claim to Insurance companies. For such claims every effort is made to resolve the denial to avoid billing the Patient.

    2. Patients' responsibility: These are claims which cannot be further worked upon and the final bill is sent to the patient for payment collection. The reasons for sending the patient a bill generally include In-Network deductibles and non-covered benefits as per the insurance plan/policy. Patients will receive a statement with a clear explanation for the balance due.

     

* Price are based on offshore working team member.

Products Services
InvoiceSpectrum Account Receivable Follow-Up
CredentialingSpectrum Denials and Appeals Management
ProductivitySpectrum Scanning & Indexing
AutoCollectSpectrum No-show Rescheduling & Appointment Scheduling
SupportSpectrum Referral Submission & Tracking
HRMSpectrum Payment Posting
WorkflowSpectrum Demographics & Claim Entry
ChargeSpectrum Credentialing
mypersonalchart Medical Transcription Services
MIPS Registry Digital Content Creation
QCDR Registry
Call 908.834.1608
New Jersey
2222 Morris Ave. 2nd Floor,
Union, NJ-07083
Phone:908-834-1608

Sales
Ph: (908)-834-1608
Email:info@Clinicspectrum.com

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