Accounts Receivable (AR management) departments of providers that serve the Occupational Health and Urgent Care Industry work very hard. It is well known that the process to recover payments for claims are quite different than the billing and recovery of a standard Group Health claim. Many of these providers find themselves struggling to stay on top of collections.
Due to the complexity of the mandates on reporting, billing, fee schedule maintenance and time requirements of each party involved in the Workers’ Compensation claim process. It’s often that we see these claims age out and have a much lower recovery percentage due to all of these variables involved. Below we outline the most common mistakes we see in collections and recovery for these difficult occupational health claims.
AR Management in Medical Billing
1. Physician Staff mistake the difference between an occupational healthcare case and group health case.
A workers’ compensation case means the patient was injured while on the job. This type of injury requires a completely separate process because it must be filed through an employer’s workers’ compensation plan.
This means the employer must authorize the claim in order for it to be considered compensable under the company’s workers’ compensation plan. This initial step alone may cause confusion and delay in collecting on these cases. The longer it takes for an account to be processed, the less likely you are to receive the full balance.
Therefore, it’s imperative that the provider has detailed instructions on file for each employer. This means providing the step-by-step directions on who’s responsible for reporting and receiving the provider’s reports of the status of the case.
2. Workers’ compensation laws vary state by state.
This makes it exceptionally difficult to collect on workers’ compensation claim if you’re an occupational health provider in multiple states. Even if you operate near a state line, you may find there are discrepancies in how to process each account as your patient may live in your state, but work in another or vice-versa.
occupational ar management
1. Paperwork is never-ending for occupational medicine AR management.
Most payers require paper submissions with extensive notes in order to be considered for compensation. In these cases, there is quite literally a paper trail that your accounts receivable department must follow in order to collect payment. With an increase in paperwork and documentation, there is always a chance that a form will fall through the cracks. Patients and their employers may need help and encouragement while navigating this process as it may be new for them.
AR Management Solutions
More time means less money.
Your accounts receivable department may find themselves simply overwhelmed with all the documentation they are required to track down and keep organized in order to successfully collect on an individual’s account.
It’s common knowledge that the longer an account goes unpaid, the less you can expect to receive from it. Due to the unique and complex nature of each Workers’ Compensation claim, there is an enormous amount of research required by case managers, HR managers, and/or adjusters. This research can take days to weeks depending on the parties involved, the severity of the case, and the availability of the patient to answer questions. Because of the research involved, the DSO days (Days Sales Outstanding) tend to extend far beyond a typical healthcare claim.
If you’re experiencing a hold-up during this part of the process, you most likely need a knowledgeable team that can identify where the delay is being caused. At Capital Recovery Corporation, our experts can pinpoint these holdups and employ solutions in order to resume processing as fast as possible.
A claim’s status request process is streamlined.
Typically, workers’ compensation adjusters are assigned to a certain client and handle all claims for that client. It’s imperative to establish a relationship with these adjusters so that you can cut down time of research and status updates for existing and new claims. It’s also beneficial to know who your top payers are and what their software platform is for requesting claim status.
Other Occupational Healthcare AR Duties
Aside from work-related accidents, occupational healthcare AR management involves invoice billing for a variety of services. Drug screens are a common billing item for occupational healthcare accounts. Employers may conduct drug screens during the interview process, randomly throughout employment, and many times after an on-the-job accident has occurred. Drug screens are typically paid by the employer and sometimes a third-party administrator gets involved. With so many people involved, payment terms and collecting your money from the right party can become very tricky, very quickly.
Debt Collection Agencies
Overwhelmed by the intricacies of collecting funds from an occupational healthcare account? Good news. Capital Recovery Corporation has represented the largest occupational medicine providers in the United States. CRC is far savvier in this line of Healthcare AR Management than any of our competitors due to our overwhelming experience in this realm.
Getting AR management help with billing, credit, and debt recovery means you can spend more time with customer relations. Contact Capital Recovery Corporation today to learn about how we can improve your business’s cash flow with our debt recovery process.