Backlogs and old ageing claims result in loss of revenue for healthcare providers. In contrast, knowledge of how to deal with backlogs and ageing claims can drastically increase revenue. In the United States, backlogs and old ageing claims cause the health sector to lose millions of dollars every year. Particularly after the Covid-19 pandemic where revenue for the entire industry has dropped, and when the health sector is trying to rebound, it is all the more important to give full attention to this matter.
First, we need to understand what a backlog or aged claim is? An aged claim is one that a health insurance company has not paid for a long time. Whereas, backlog claims are those claims which are not seeing any progress due to multiple reasons.
The backlog & ageing claims can occur due to several reasons. One of them is transitioning. Transitioning happens when a health care provider hands over a medical task or the whole billing process to a new company. When it happens, there are bound to be a few claims that have not seen any progress for a long period of time due to numerous reasons such as health insurance issues, clearinghouse issues, pre-existing conditions, questionnaires, and credentialing issues with the insurance. It leads to giving birth to more old ageing or backlog claims.
The good news is that multiple practices can help any healthcare provider to reduce ageing and backlogs claims and as a result improve revenue cycle management. Take a look at some of these practices related to backlogs and ageing claims handling.
1. Identify Denial Claims Pattern:
Denials are the topmost cause of the increase in backlogs and ageing claims. Every denial occurs for a specific reason or due to an error committed at a specific point. The example of such mistakes include medical coding errors, not understanding terms and conditions of the insurance policy or not doing proper follow up with patients regarding documentation etc. Identifying patterns in denial claims, especially if similar errors are occurring repeatedly, can be helpful. After you identify them, you can take corrective measures to prevent them in the future, such as improving your software or retraining your personnel.
2. Overhauling Software:
Automation software has made great strides in medical billing in recent years. THe technology has made a difference to medical billing, scribing, data entry, and AR department software. A health care provider can decrease backlogs & old Aging Claims by updating the software and automation processes. It will make your medical billing teams the best in dealing With Backlogs & Old ageing Claims.
3 Looking into Patients’ Overall Record:
From the moment a patient seeks out medical care, it is advisable to check his or her insurance details and overall health record. It will help you to identify any recurring claim issue that has previously occurred related to any previously taken treatment. Identifying them can decrease the probability of experiencing the same at your health facility and result in decreasing backlogs and old ageing claims.
4. Retraining of Personnel:
Medical billing does see regular updates that affect the working of many departments such as medical coding, scribing, payment posting etc. If your staff is not getting training as per the latest updates, you are bound to see an increase in denial. Getting your staff training on the latest updates will make your medical billing team the best in dealing With Backlogs & Old ageing Claims.
5. UNcollectible claims:
It’s stressful to see stale collectable claims on their reports that have no hope of being recovered. For e.g, if you have a two-year-old claim, and you can’t bill the patient and do not have any grounds to appeal. It is better to dispose of such claims. But don’t forget to make note of why the claim became uncollectable.
6. Track down bills that never got sent:
To find the backlog you can look at bills that never got sent in the first place. You can find such unsent bills by checking your “Medicare return & billing editor queues provider reports”.
7. Hire A Clearinghouse Agency:
Hiring a healthcare claims clearinghouse can always prove to be a wise decision & make you the best in dealing with backlogs & old ageing claims. A healthcare claims clearinghouse could be a good investment for you if you have the funds. They will make sure that the insurance companies receive your claims correctly and file them correctly the first time around.
Conclusion:
Medical billing services always face issues with backlogs and ageing claims. However, health care providers can adopt some practices to easily turn your medical billing process the best in dealing with backlogs & old ageing claims. These practices can be retraining, adopting automation software and identifying issues. An outsourcing company can provide you with the above functions at a reasonable price. Virtual Healthcare is one such company that has great experience, resources and professionals to help you medical billing
Contact us today to learn how we can help you boost your revenue cycle management.