How to Run an A/R Review Meeting

Quality Healthcare Resources
June 30, 2022
July 7, 2022
Polaris Group Profile
Polaris Group
July 7, 2022
Summary

Learn why your facility needs to have monthly A/R review meetings and how best to structure these meetings to improve financial health.

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Monthly A/R review meetings should be a key component of every nursing home’s financial operations. We know you might be thinking, "Another meeting?!" but consistent, structured, and actionable reviews are the best way to make sure your A/R strategy is literally paying off. An A/R review will ensure you collect the money you're owed, efficiently use staff time, and prevent recurring billing issues. Here's how you can get started, as well as take your meetings to the next level:

How to structure your monthly A/R review meeting

Your administrative team should lead an A/R review meeting on a monthly basis to ensure you're making progress on unpaid claims, using your staff’s time judiciously (especially if you don’t have dedicated A/R personnel), and addressing any recurring billing issues. The meeting should be led by the administrators or executive financial staff and include the billing managers and staff responsible for the A/R. Administrators and financial leaders are responsible for analyzing the aging report and helping to set A/R strategy. Billing team members are responsible for sharing progress made on aged claims.

The agenda for the meeting should include reviewing your A/R trends (again, make sure you analyze your aging report!) and discussing each outstanding account on your aging. Here are the account details you should discuss:

  • Reasons the accounts remain outstanding
  • Progress made on the account since last month’s meeting
  • Plan of action towards payment.

If your team can’t review all aged accounts in the allotted meeting time, we recommend prioritizing accounts based on timely filing requirements of insurance companies and what has rolled from 60 to 90 days or anything over 90 days. If an account continuously rolls, it might not be getting worked or it might be getting resubmitted for processing without drilling into the root cause of the denial.

Practice a "root cause analysis" during your A/R meetings

The deeper you drill into the root cause of an unpaid claim, the more likely you are to get it paid and to correct upstream process and training gaps. Instead of breezing through progress updates on claims, take a moment to ask more specific questions about the data in front of you. Here are a few example:

1. Why are there still balances on accounts if payment has been received?

Investigate and review your payer trees. Are rates booked correctly? Make sure that the business manager sees and understands payer contracts so that the correct rates are billed.

2. Why is the facility writing off dollar amounts?

Here, listen for why claims were not billed timely and ask follow-up questions about what processes were used.

3. Why are there credit balances?

Are there issues with Medicaid share of cost not updating timely, coinsurance booked to the wrong payer, or cash posting errors?

Once the respondent has answered, continue to ask “why” until you’ve isolated the base issue. Too often team members will ask a payer to resubmit a denied claim for reprocessing if they or the payer don't know why the claim was denied in the first place. Demonstrating a root cause analysis during your review will help your team ask similar follow-up questions either to themselves as they internally research the claim, or to the payer representative as they follow up. A clearer understanding of the cause of the problem means faster resolution and future prevention.

Meetings get you aligned and accountable, action is critical

Consistent and structured A/R meetings will help you analyze A/R trends and ensure your team has the right mindset, approach, and prioritization to efficiently tackle your aging. At the end of the day, it’s all about collecting what's owed to you as efficiently as possible. If you’d like more insight on A/R best practices and support, contact us here. Our QHCR team is always happy to help!

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