The Ultimate Guide To Accounts Receivable Process

Accounts Receivable

The accounts receivable team manages the flow of healthcare revenue via the invoicing and collection process. Right from follow-up and debt collection of late payments, the purpose of this process is to provide healthy cash flow to completely support profitability and practice growth. Here is all you need to know about the healthcare accounts receivable process.

What is the accounts receivable process in healthcare?

Accounts Receivable (AR) is the money owed to Providers or medical billing companies for the medical care rendered to patients. The generated invoices are sent out to insurance companies or patients for payment. The staff must keep a tab on the AR and see if the payments reach on time. In simple words, the Accounts Receivable process is of identifying denied/unpaid claims, re-filing the corrected claims, minimizing AR days, and eliminating aged AR.

The real purpose of the accounts receivable process

Improving Collections

The longer the accounts go uncollected, the greater the loss of revenue and the greater the number of resources that the practice would need to set aside for collection efforts. The key to resolving this issue is to include accounts receivable aging and days or months outstanding in a monthly key indicator financial report. Keeping an eye on the timeframe of the balances will provide an idea about

  • The age of the insurance claims
  • The number of times statements have been sent to patients
  • How long it is since the last payment was made
  • How close the claims are to reaching the timely filing limit
  • How many claims did not go through

The best strategies to improve collections

Analysis of collections by payer: It is necessary to identify which insurance companies are slower to pay and which ones have a higher volume of denials

Assessment collections from patients: The practice needs to collect all the copayments, prepayments, and outstanding payments at the time of service. Patients should be educated on the payment process before or at the time of service

Calculation of the frequency of errors that delay collections: Practices should take note of repeated errors in gathering patient data, coding, billing, or other processes. These are indications of the areas in which changes need to be made.

Leveraging the medical billing program: The software should be able to notify the staff when accounts are past due so that follow-up steps can be taken

Involvement of staff: There must be a team to track specific payers; regular meetings should be called to discuss A/R status and problem areas, and identify collection techniques that work.


A good stream of revenue

One of the main sources of revenue for a medical institution, such as a hospital, is the account receivable payments they get either from the patient or their insurance company. If a hospital can manage its A/R system properly, it will receive the revenue it needs to stay open and treat more patients.

Therefore, hiring an effective medical billing professional who specializes in A/R follow-ups will assure that your practice, clinic, or a larger healthcare facility is successful and equipped to treat more people.

Easier and quicker payments

While certain federal and state mandates affect how quickly claims are processed, your medical billing specialists may shorten or lengthen the period between a patient’s account being charged and when its balance will be paid.

What they also do is seek the accounts with outstanding charges and then discuss the best strategy for ensuring payment, then finally implementing it until the payment is secured.


Increased Reimbursement Optimization

Another important purpose for a medical biller’s A/R follow-up service is that it can increase the chances of getting your medical service fully reimbursed. Some insurance payers deny claims due to some discrepancies in the documents sent along with the claim itself.

Medical billers can commit a follow-up by directly contacting the insurer and requesting the precise reason for denial. If it was due to certain pieces of information missing from the claim, then a corrected claim can be filled and sent again, resulting in the A/R being paid.


Every healthcare organization must track and obtain its accounts receivable during the medical billing process.  A great number of medical organizations utilize expert accounts receivable services to ensure that these payments are appropriately filed, processed, and received.

Outsourcing healthcare accounts receivable services to CapMinds can help your healthcare organization effectively deal with your accounts receivable process. We will not only save your operational costs but also help in improving the cash flow.

At CapMinds, we can follow up on your pending claims, trace the reasons for claims denials, track outstanding receivable balances by the customer, and by the date when payment is due, initiate collections, and provide periodic reports.

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