Accounts Receivable & Your New EHR: 5 Steps to Success

Accounts receivable is often one of the most difficult parts of transitioning to a new EHR. But it doesn’t have to be this way.

Today’s ever-changing healthcare climate puts heavy demands on organizations. They’re consistently encouraged to increase patient engagement, keep up with the never ending changes to insurance policies, as well as comply with value-based care. All while treating patients to the best of their ability.

These demands have caused organizations to rely heavily on their IT systems and more and more of them are realizing that the systems they’re currently using just aren’t cutting it. The need for automation, data analysis and detailed reporting often requires the implementation of a new EHR.

While this may solve the needs of the future, it can also create severe issues for your current working climate. IT system transitions, although necessary, are complex and affect nearly every aspect of an organization. One of the most critical aspects of a PM system transition involves the handling of accounts receivable (A/R).

The following are 5 steps every organization should take as they prepare to wind down their A/R during a system transition.

1. Track Down All Account Receivables

The first, and most important, step in this process is making sure all of your receivables are accounted for. Basic reporting will provide you with all receivables that have been posted. However, finding and managing missing revenue is slightly more difficult.

The majority of missing revenue generally falls in one of three categories:

  1. Unbilled
  2. Rejections
  3. Appeals

Be sure to set up a strategic plan that consists of reaching out to providers to ensure all of these receivables are included in the winding down process.

2. Set Reasonable Collection Expectations

Let’s be honest; every organization would be thrilled to collect 100% of their receivables. Unfortunately, there are several reasons that’s not going to happen. First and foremost being the time and resources you have to dedicate to said collections. This is why we recommend performing a collectability analysis.

This report will help you decide what resources you should devote to the collection effort. Once the analysis is complete you’ll want to choose a cut off age. This helps to weed out the collections that just aren’t worth the time.

According to industry standards, 90% of accounts that are less than 60 days old can usually be collected. The collectability of receivables aged 121-150 days falls to 55%. A/R over 180 days old takes a serious dive at a 5% chance of recovery.

3. Consider Outsourcing

Because your resources are limited, it’s important to evaluate the pros and cons of outsourcing a portion of the receivables to a third party.

The beauty of an outsource firm is they typically charge a percentage of what they collect regardless of the resources required on their end. Therefore, it’s usually more cost effective to have them handle the more difficult collections at a fixed cost. This helps to avoid using up your own internal resources as well.

You can also choose to start out managing all collections internally, then pass the baton to an outsourced vendor once it becomes too much for you to handle.

4. Know Your Legacy Limits

It’s important to know how long you need to keep your legacy data. The standard requirement is seven years, but some organizations have an extended policy. Make sure you have a clear understanding of regulatory requirements and internal organizational mandates for record retention and level of detail well ahead of your transition date.

5. Choose an Archiving & Storage Solution In Advance

A/R drives an organization’s cash flow and must be managed carefully during a system conversion, which is why it’s crucial to have an archiving and storage plan from the get go.

While some organizations choose to manage this on their own, that may not be in the best interest of their staff. Archiving data requires significant resources in the form of people, hardware and software. Triyam’s provides an affordable solution that cuts down on the use of your own resources.

Using an archiving system which not only stores the historical clinical and financial data, but also has ability to work down past AR is crucial. Triyam’s Fovea provides features such as tracking down remaining AR and posting payments and adjustments as collections come in. In Fovea you can also re-bill past claims or reprint past invoices or statements. It’s also easily accessible, searchable, and complies with the rigorous security and privacy standards required in the healthcare industry.

Summary

Although it can be overwhelming to look at this process from a 10,000 foot view, it’s really all about preparation. The best way to keep your revenue cycle operating effectively is to begin planning for the A/R work down early in the system conversion process.

Evaluating your existing A/R processes and planning for contingencies, will go a long way in better managing your legacy A/R while simultaneously ensuring a more successful transition to the new system.