It’s a time of change for all businesses in the medical accounts receivable world. Budgets are tight and new implementations of the Affordable Care Act are causing major change throughout the industry. Recent research from the Centers for Medicare and Medicaid services suggest that practices are not getting paid on approximately 18% of the claims they submit. There’s never been a better time to evaluate your business practices and discover how others are succeeding.

Best Practice #1:

Choose Software Wisely

Underpayments are a critical problem in this field, and the right software can make a big difference for your bottom line. Your ideal software solution is one that can track contracts easily and efficiently to identify actual payments with what the practice is supposed to get. In an overloaded practice, employees don’t really have time for this task, and software that can point out errors and opportunities to get the money the practice is entitled to can be a blessing.

  • You also need software to automate the workflow processes in-office. One great example of a software response to a daily activity is the computer signaling the need to begin claims processing as soon as a patient checks out of the office.

Best Practice #2:

Make Use of Business Intelligence Tools

The popularity of mobile and web apps in the last few years has produced some highly innovative business intelligence tools to analyze your data. Analyzing data can be time consuming, but these applications make it easy to condense what the practice is doing well and where the practice can improve. Use this information to brainstorm about procedures that can be changed as a result and then track the progress of the improvements.

  • Mobile applications for business intelligence are easily synced to your phone or tablet to provide quick and current data about your business.

Best Practice #3:

Verify that your advanced collections application is up to par

Make workflow seamless for your accounts receivable specialist. A “task list” or “work queue” should be part of the program that you use so that employees can easily click through and accomplish the projects that you need. As mentioned above, it’s important that the employees are able to track denials and underpayments. Not only do these “flag” issues of concern but they help to keep employees on track of critical tasks. Ultimately, your employees are able to use their time to focus on more critical aspects of the business and you benefit from increased attention to processes and payments via software.

  • The software should be able to categorize the different denials by type so you can view trends over time and allow you to develop a plan to address the number and type of denials.

This year, focus your business on best practices to help with growth, efficiency, and meeting budget goals. Choose software wisely to allow for streamlined business processes, employ business intelligence tools to analyze data, and use advanced collection information to track money and claims.



Clean Claims On First Submission




HIPAA Compliance


Increase in Collections

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