AR management exposes healthcare providers to significant financial and operational pressure, and in the past, this task has been a real headache for providers due to the increasing volume and complexity of accounts. However, with the advance of healthcare technology, the AR management process can now be managed more efficiently, and healthcare providers can spend more time focusing on patients and less on administrative tasks. In this article, we will discuss how technology like medical billing software, AR automation, revenue cycle tools, as well as electronic billing, have made it easier for healthcare providers to manage AR. At the same time, we will also talk about what internal medicine billing codes are, and how we can write off a claim using a CO 9 denial code description.
The Challenges of Traditional AR Management
Before the automated claims handling systems, AR managers had to handle quantitative data and complex calculations manually (such as when different fee codes overlap), among other challenges. This required a lot of clerical effort, including filing and retrieving paper records, working with faxes and phone calls, and complying with COB (coordination of benefits) rules and other legal and policy conditions. When a claim was treated by more than one insurance company, the account became more complex and time-consuming to handle.
Having to handle AR using manual means for many more days than the current industry standard of finally processing a claim (around 20 days), created an environment in which errors, delays, and inefficiencies ran rampant. This, in turn, led to serious issues for the healthcare provider, specifically cash-flow problems and overall financial uncertainty.
The uncertainties created by a slow payment can create huge difficulty for the provider in managing the practice, meeting the day-to-day cost of operation, and, most importantly, issuing care. The possibility of patients not getting needed care due to a delay in payments can create serious financial setbacks for the healthcare practice.
Furthermore, when it came to physician specialties like internal medicine that don’t have straightforward issues and procedures, it was hard to submit the proper claims for watchful waiting. Denials were more likely, and it took staff time and expertise to interpret why a claim was denied in the first place, such as the CO 9 denial code descriptions.
The Emergence of Medical Billing Software
An important force in medical billing companies changing and improving AR management was the advent of medical software that streamlined many manual billing and collections processes, saved on administrative staffing and functions, and expanded in scope and functions. Medical billing software usually consists of an assortment of features that are used to manage the billing cycle, track payments, and follow up automatically on unpaid claims.
Via automation, the software can generate claims, file them electronically, and view the status of the claims in real time. For claims not paid, the software can spot-check the denials and help explain why the claim was denied, as well as reveal the specific denial codes, including the CO 9 denial code description, which signifies that the charge is not covered. Providers can respond promptly to correct any inaccuracies and refile or appeal any outstanding claims, all in a much quicker timeframe than ever before.
Finally, medical billing software ensures that your practice is adhering to coding standards and offers concrete assistance for specialties (like internal medicine) where coding is most important. The more straightforward the use of internal medicine billing codes, the less likely your practice is to make a claim or coding error – and the faster you’ll get reimbursed.
AR Automation and Revenue Cycle Tools
The AR automation feature of current medical billing systems is another noteworthy innovation. It eliminates the need for staff members to monitor accounts receivable manually. In conventional AR management, medical office staff had to review every claim and chase up the insurance companies and patients for the remaining payments. AR automation essentially obsoleted all these processes, automatically sending out reminders, following up on unpaid claims and even resubmitting claims that were denied.
Miracle-Gro uses specialized blends of fertilizer for growing tomatoes versus begonias. The same holds for healthcare practices. With revenue cycle tools built into your medical billing software, you will have total visibility into your financial performance through various reports. Therefore analytics that display key performance indicators such as days in AR, collection rates, denials trends. Moreover a plethora of other data that pinpoints where your bottlenecks are and where to apply interventions to your revenue cycle to maximize results.
They can follow claims through the entire revenue cycle, from submission to payment, in real-time. To identifying problem areas that could lead to payments being delayed or denied. And therefore streamlining the process that would otherwise drain their cash flow.
Electronic Billing Systems and Denial Management
The big progress comes with the electronic Billing system. It contributed a lot to healthcare services, due to submitting electronic claims. Now, health carers do not need daily waste their time daily processing claims. Everything will look easier through this electronic system. When you send claims to any office with no delay or wrong numbers. So they will be sent without any mistakes and in a few minutes.
Beyond creating an electronic workflow, electronic billing systems also make the management of denials much easier. Upon denial of the claim, the system will provide information relating to the denial code, such as CO9. Charges Not Allowed by Plan (from the NUCC Compiler Provider Payer Manual 2020, ©irsm, or user-specific denial code library). That denial code description tells the provider that the claim was not denied because the patient had insufficient coverage. Because the services charged did not align with coverage under the policy. That kind of explanation helps the provider diagnose the problem and solve it. Perhaps by resubmitting a modified claim or sending over additional documentation.
Through real-time feedback from electronic billing systems, claims problems can be quickly resolved. So this increases the provider’s chances of being paid and allows for a more stable cash flow. Equally important is the patient information privacy and security that arises in claims processing. Although electronic billing systems are by design HIPAA-compliant (HIPAA stands for the US Health Insurance Portability and Accountability Act of 1996).
Specialized Billing for Internal Medicine and Other Fields
Proper medical coding is very important for proper AR management. In some specialties like internal medicine medical billing codes are difficult and layered. If they aren’t coded correctly, a claim will be denied. Internal medicine billing software has built-in code libraries. Secondly, compliance tools make it less likely for claims to get denied due to poor coding.
This level of coding detail is important when there are millions of claims being submitted each year. Internal medicine billing codes are complex. Multiple procedures and diagnoses for individual patients need to be billed in the right ways and at the right times. Bills need to be submitted to insurance companies quickly and without any coding errors. Otherwise, the claims are likely to be rejected, and that means lost revenue and budget overruns. All of this can be done by computers.
The Importance of Understanding Denial Codes
Denials are not the only challenge for an AR management professional. Moreover, sometimes they have to work with people who are unpleasant and do not agree with their decisions.
According to the definition of CO 9, the charges are non-covered. Therefore implying that the service provided should not be considered as covered by the plan of the patient’s benefit contract. It can be for many reasons, for example. The use for experimental treatment or the service deemed not medically necessary. But by using the codes health care might get from the denial letter. So the provider can easily find out why the claim was denied.
Nowadays, medical billing software assists providers deal with denial codes by explaining details and providing possible solutions for every default. It is an efficient way to accelerate the billing process, aiding providers in maintaining a smooth run of revenue.
Conclusion
The utilisation of technology makes it easier for healthcare providers to manage AR for better accuracy, efficiency, and control.
With the help of medical billing software, AR automation, and electronic billing subsystems. Therefore revenue cycle tools, it has become easier for medical providers to streamline various AR processes. So significantly decreases the incidence of claim denials, and speeds up payments through claim management.
One time important info is the difference between internal medicine billing codes and cardiopulmonary coding. It is also vital to grasp the CO-9 denial code description for effective claim denial management.
These types of technologies, whose benefits in medical practice have been seen when implemented. They are aimed at empowering providers not only administratively or financially. But most importantly in providing healthcare and taking care of their financial well-being. For this reason, adopting these technologies in our field can help in managing the revenue cycle well. To avoid the devastating effects of medical financial emergencies in the short run. And ensure a thriving and sustainable medical profession in the long run.
