Why Revenue Problems Do Not Always Start in the Billing Department
Why Revenue Problems Do Not Always Start in the Billing Department When revenue slows down, the billing department is often the first place people look. Was the claim submitted correctly? Was the payer contacted? Was the denial followed up? Was the patient balance collected? Those are important questions. But sometimes the billing team is dealing […]
The Operational Decisions That Quietly Affect Practice Revenue
The Operational Decisions That Quietly Affect Practice Revenue Practice revenue is often discussed through numbers. Collections. Aging. Denials. Payments. Write offs. But many of the decisions that eventually affect those numbers happen much earlier. A front desk employee confirms insurance information. A staff member decides where to document an authorization. Someone follows up on an […]
What Your Write-Off Report May Be Telling You About Your AR Process
What Your Write-Off Report May Be Telling You About Your AR Process A balance is written off. The account disappears from active AR. The report looks a little cleaner. And the team moves on. But what if the write-off is telling the practice something worth examining? Write-offs are often viewed as the final stage of […]
Why Pending Claims Can Be More Dangerous Than Denied Claims
Why Pending Claims Can Be More Dangerous Than Denied Claims A denied claim gets attention. There is a reason code. There is a problem to investigate. And someone usually knows that action is required. A pending claim can be different. It may look like the payer is still working on it. The account remains open, […]
Why Unapplied Payments Should Never Sit Unreviewed
Why Unapplied Payments Should Never Sit Unreviewed The payment arrived. The money is in the practice’s account. But no one can confidently say which patient, claim, or service it belongs to. That is where an unapplied payment becomes more than a posting task. Until the payment is correctly matched and reconciled, the financial picture may […]
Why Patient Credit Balances Deserve More Attention Than Most Practices Give Them
Why Patient Credit Balances Deserve More Attention Than Most Practices Give Them Most AR conversations focus on money that has not been collected. Unpaid claims. Denials. Underpayments. Old patient balances. But there is another type of balance that deserves just as much attention: Money sitting on an account that may no longer belong to the […]
The AR Risk Hidden in Payer Recoupments
The AR Risk Hidden in Payer Recoupments The claim was paid. The payment was posted. The account looked resolved. Then, weeks or even months later, the money is taken back. Payer recoupments can create a unique AR challenge because they reopen accounts that may no longer be receiving the same attention as active denials or […]
The Difference Between a Denial, Rejection, and Underpayment—and Why It Matters
The Difference Between a Denial, Rejection, and Underpayment—and Why It Matters A claim has a problem. But what kind of problem? Was it rejected before it could be properly processed? Was it processed and then denied? Or did the payer issue payment, but for less than the practice expected? To a busy medical billing team, […]
When the EOB and the Patient Account Do Not Match
When the EOB and the Patient Account Do Not Match The payer has processed the claim. An Explanation of Benefits is available. The patient account shows a balance. At first glance, the numbers should tell the same story. But sometimes they do not. The EOB may show one amount as patient responsibility while the account […]
Why Secondary Claims Become an AR Blind Spot
Why Secondary Claims Become an AR Blind Spot A primary claim gets paid. The payment is posted. The account looks better than it did before. But there is still a remaining balance. For many medical practices, this is where secondary claims can quietly become an AR blind spot. The primary payer may have completed its […]