Missing out on working high dollar value surgical claims can be a significant revenue loss for surgical groups, to prevent such unpaid and unrecovered AR we have identified successful AR management methods. These proven methods will assist surgical centers and groups to streamline the AR in terms of reducing AR days, fastening collections, getting patient reimbursement, avoiding denials, and creating contingency plans for any upcoming high dollar value claims that need a keen eye on and regular follow-ups to ensure the collections are compensating with the administrative experience. Hence boosting your surgical/surgery claim account receivables is the best practice!

1. Managing Accounts Receivables for Surgical groups’
High-Dollar-Value Claims
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Effective Accounts Receivables Managing Methods
for Surgical Group’s High-Dollar-Value Claims
Overall health care expenditure is slated to extend
exponentially over the course of consecutive few years, and
personal payers expect to foot an outsized portion of the bill.
CMS estimates national healthcare expenditure to grow at a
mean annual rate of 5.4% through 2028. This outpaces
average projected growth in the gross domestic product
(GDP) by 1.1% points, and healthcare’s share of the economy
to a walloping 19.7% of gross domestic product by the tip of
the amount.

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Medicare can expertise the most significant increase in health care expenditure because the population ages.
However, non-public payers are to be expected to account for nearly 5% of national healthcare expenditure
through 2028, CMS researchers reported.
To put that into perspective, the U.S.A. spent $3.8 trillion on health care in 2019. Payers described virtually three-
quarters of paying that year, with non-public payers shelling out $1,195.1 billion, the yank Medical Association
(AMA) found the National Health Expenditure knowledge. Notably, this increase in disbursement occurred before
the COVID-19 pandemic hit.
As healthcare disbursement will increase, payers should notice a worrying new trend: healthcare provider partners
submit a lot of high-dollar claims as new therapies and technology emerge, and also the aging population grows,
requiring a lot of complicated, intensive services.
These high dollar value claims result in major denials and piled up AR because certain insurance companies just
do not make an effort to pay the healthcare providers for the services rendered. Here we can identify certain
methods to resolve high dollar value Accounts receivables and get the claims paid.
Effective strategies to manage Accounts Receivables for surgical groups’ high-dollar-value claims

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Driving Revenue Systematically
It’s truthful enough to say that the payments due from either the patient
or the non depository financial institution, are among the chief sources for
generating revenue for any attention center. It will get pleasure from a
healthy revenue cycle if all the payments are received while no
discrepancies or delays after they contour their Account Receivables (AR).
This way, it’s almost easier to thrive and focus additional on providing
quality medical aid.
Speeding-up & Secured Payments
The interval is significantly affected because of some mounted directives
of the state and federal. However, the amount from the patient’s account
gets charged till the time the remaining balance is collected is also
reduced or enhanced by the medical billing specialists. They determine
those AR that is unpaid and coin a method and follow it constantly to
secure the payment and guarantee collection.

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AR Followed-up Promptly
To own a homogenous income, it’s important to follow up on the AR
promptly. An experienced AR team ensures observation of all the claims
filed and promptly implements an idea of action if the claims fail to urge
paid within thirty days time window. By doing this, they assist in avoiding
outstanding debts or underpayments.
Facilitate taking care of a wonderful Patient-
Provider Relationship
The key to receiving on-time payments while not having hassles is to possess a
wonderful patient-provider relationship. Once self-pays are introduced, the medical
asking firms get compelled to rely additional on the patients than the insurance firms
collect payments upon. The AR management team ensures to temporary the patient
regarding the due expenses before rendering the medical aid. And just in case of any
unfinished charges, they work on reducing the delays by adeptly following up with
patients through emails or phone calls.

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Keeping Denials Unfree
Managing claims may be a crucial demand within the assets method. With
the assistance of their specialized and complete team, the AR
management identifies the underlying reason for the denial and quickly
works on decisive the cause for rejection, addresses the difficulty, and re-
files the claim while not abundant a delay. They additionally probe into the
patterns of those denials to research for avoiding denials subsequently.
Get pleasure from an increased & Maximized Count
Of Reimbursements
Your practice gets pleasure from obtaining reimbursed absolutely for the medical aid and
repair given the help of the account due to management’s consistent and prompt follow-up.
whereas the claims get submitted, there are higher possibilities for discrepancies within the
submitted documents inflicting the insurance payer’s contract to deny the claims. In such a
case, the medical asking team will directly connect with the insurance money dealer to spot
the particular cause for rejection. just in case the error occurred because of missing data
within the capsulated documents, right away, they’re resolved and re-submitted to make sure
payment of AR.

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Conducting Frequent Audits & Report Submission
The frequent conducting of audits often is one of the highest best practices of account assets management.
By doing this, you’ll find areas that need improvement, determine the problems, and evaluate the risks
concerned. Upon the last such audits, reports are ready and submitted, which clarifies the outstanding
debts, helps keep the claim denials unfree and ensures collection payments directly
BillingParadise has assisted various surgical groups including orthopedic, cardiology, urology, cardiology,
etc, to resolve their unpaid high dollar values surgery claims AR. These surgical groups have experienced
constant denials or no response from insurance companies resulting in approximately over $500,000.00 in
unpaid AR claims, of which we have recovered 90-95% of it.
Schedule an in-person meeting with one of our AR experts and they will visit your practice to provide more
insight on the AR problems and how to avoid future unpaid claims and manage Accounts Receivables on
high-dollar-value claims.

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