Urgent Care Practive Billing

Business Challenges

Setup:

• EMR – Electronic Medical Record is a new concept.
• Total Accounts Receivables – $532K
• Insurance AR – $380K (90+ AR at ~65%)
• Patient AR – $152K
• Collections – $120K
• AR Days – 90 days
• No proper denial work or documentation.
• No timely patient statements.
• Lack of follow-ups on claims.
• Only benefit: Easy access to patient records.

Appropriate Steps Handled to Reduce the AR

• Teleconferenced with the client to understand the EMR workflow.
• Reviewed charge errors, modifiers, and applied correct billing rules.
• Identified and filed missed charges due to system issues.
• Analyzed rejection trends and reduced them through training and system tweaks.
• Created a structured patient statement schedule and implemented it.
• Defined patient AR policies tailored to the practice.
• Handled denials with timely appeals and supporting documentation.
• Corrected incorrect copay and deductible allocations.
• Resolved outdated diagnosis code issues with software vendor assistance.
• Sent weekly error/missing ticket/future appointment reports for accountability.

Key Achievements

• Current Total AR – $155K
• Insurance AR – $100K
• Patient AR – less than $50K
• Collections – $133K to $140K
• Current AR Days – 26
• Highest Collection in 5 months – $135K

“Overall I am pleased with the support. The response time and communication is fine. Knowledge about billing and claims is excellent.”