3 Must-Haves in an AR Specialist

Your staff is working hard to ensure smooth admissions and proper care for each patient. The billing department is continuously receiving new claims and is finding it difficult to process them with the constant onslaught of looming deadlines. You have come to terms with the fact that it’s time to hand off some of the workload to a competent new hire or third-party so your receivables team can focus on the current; making sure each patient is receiving the care they need.

However, while you understand that this is an essential step in enabling your facility’s success, how does one go about finding an individual or company qualified enough to handle one of the most integral aspects of your business? After all, the wrong hire can disrupt your entire cash-flow!

As a company that has been working with hundreds of SNFs over the last decade, here at LTC we’ve seen it all. We’ve put together this list of the top three must-haves facility operators should check for when considering handing off a facility’s AR to specialists.

1. Expert Knowledge of your particular state’s CMS, Medicaid/Medicare and MCO rules

Look for an individual/ company that is familiar with your state and its various regulations/laws. Being that Medicaid rules vary, sometimes very subtly, per state, specialists that are familiar with the nuances and requirements are per region, will not only help things get processed, but may allow for a lower margin of denied claims.

2. Strong Relationships with HMOs and MCOs

As in every industry, positive and well-rooted relationships are important. An individual or company that has strong relationships with the various insurance companies can help you get better contracts, better timely filing – time allowances for filling a claim and are key when issues arise.

3. An Emphasis on Technology; Software and Support

A technologically advanced company that can integrate with your billing software (most billing software doesn’t have the capabilities to track follow-ups properly) and that can properly track day to day workflow will ensure that nothing falls through the cracks and all claims are followed up. And when cleaning up aging AR, proper technology can provide analytics and help pinpoint what caused these claims to fall behind.

Keep this checklist in mind when considering a receivables specialist for your skilled nursing facility to ensure a smooth transition.

LTC Consulting Services is the long term care industry’s premier medical billing service and off-site central business office. LTC’s custom business management packages for health care facilities offers peace of mind while substantially increasing and maximizing their revenues.