This article describes how the MBW accounts receivable and calling team worked to fix the problem in submitting the primary claims to Indiana Medicaid by looking for an alternative way to submit the claims, thereby preventing timely filing issues and obtaining payment duly.

Most Central Billing Offices (CBOs) and outsourced billing companies rely on dedicated accounts receivable calling to overcome their receivables' challenges. Running an AR calling team needs a solid understanding of the receivables patterns and diligent processes to follow-up and close underlying issues. In this article, we list some of the critical operational issues and solutions to overcome them.

Physical Therapy billing requires expertise to ensure holistic and sustainable improvement. Medical Necessity and prior authorization issues can cripple a practice’s financial health. Structured revenue cycle processes can help Physical Therapy clinics grow and thrive. Diligent tracking of issues and working with physicians can yield as much as 2X improvement in collections and reduce denials by as much as 50%. Get the strategies in this case study.

Worker’s Comp Claims present unique challenges to billers and claims follow-up agents. By following the processes and guidelines outlined by the Payer, you can improve collections multi-fold.

Recovering claim dues from payers for physician assistance claims requires intricate knowledge of payer-specific guidelines. Medical Billing Wholesalers’ denials research team helped the client identify and resolve out-of-network claims.

With a focus on recovering denials of PA claims from UHC and Oxford, we rebilled the claims after adhering to the payer-specific guidelines and were able to recover over $80K of A/R, while reducing the monthly denials from 73 to 11.

Standardized billing and coding practices for Spinal Cord Stimulator (SCS) Procedure Code 63650 reduce medical necessity denials and help collect 281 claims valued over $ 300K in 2 years. The Customer saw over 36% improvement in Collections, as much as 75% reduction in old AR over 61 days, and reduction of denied SCS claims from 68 to 8 over a 7 month period.