Legion Healthcare Solutions

Account Receivable Management

For most providers, cash flow is the only source to keep their medical practice running, so how do you keep your cash flow synchronized with your practice’s demand. AR is the amount that needs to be reimbursed to a provider by the patient or insurance company for the services provided.

So let's understand how are AR days calculated for Legion Medical Billing company?

Providers measure AR with a number of days, dividing the total AR amount by the practice’s average daily charges. If your practice is 15 days in A/R that means you have not been paid for 15 days worth of work. AR can be classified by age: 0-30 days, 31-60 days, 61-90 days, and so on. A provider is said to have the best cash flow is they have the highest AR in the first bucket of 0 to 30 days.

Our AR team is responsible for understanding why claims are denied and how to appeal against the denial to make maximum reimbursements. Most payers usually have a team upfront to communicate why claims are denied; our dedicated team follows-up on the denied claims helping them to maximize the cash flow.

A Legion specialized team with AR experience can follow-up with payers and process that needs to be followed for reimbursement, it can either be charge entry, verification, and payment posting. Many of the payers today deny claims if the rules aren’t followed during the claim submission, hence having a dedicated AR team reduces the percentage of denials.

Step 1 Initial Evaluation

In this stage, our AR team identifies and analyzes the claims listed in the AR aging report. For claims 31 to 60 and 61 to 90 are given the highest priority, a review is conducted about the complete provider's policy and identify which claims need to be adjusted first.

Step 2 Analysis and Setting Priorities

Once the claim is identified, they are divided into two categories uncollectible or claims for which the payer has not paid according to the contractual rate. Several teams are involved during this step, and it is completed within two days.

Step 3 Collection

The claims after analysis and setting priorities are refilled with identifying all necessary billing detials. After completing the posting of payment, details for outstanding claims are generated and then followed up with payers.

Complete understanding of claims

Minimize the outstanding accounts

Follow-up for the claims currently denied

Recover claims kept pending due to lack of information

Follow-up with payers for overdue payments

Improved cashflow

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