Aging Receivables, Payment Timelines, and How OneSource RCM Solves Rejections, Denials, and Portal Challenges

In the world of healthcare, aging receivables can be a serious roadblock for practice owners and administrators. Understanding the nuances of payment timelines and the challenges presented by various billing portals is crucial for maintaining a healthy cash flow. This blog aims to provide actionable insights into how aging receivables impact your practice and how OneSource RCM can mitigate these issues effectively.

What Are Aging Receivables and Why They Matter

Aging receivables refer to any accounts receivable that have not been collected within a specified period, typically categorized into different aging periods (e.g., 30, 60, 90 days). When a practice has significant aging receivables, it indicates that payments for services rendered are delayed.

Reducing aging receivables is essential for several reasons:

• Improved Cash Flow: Money tied up in receivables can stall practice operations, preventing timely investments in essential resources.

• Operational Efficiency: Fewer aging receivables mean less time spent in follow-ups, allowing administrative staff to focus on patient care rather than billing matters.

• Patient Trust: Timely billing and collection instill confidence in your patients, leading to better patient relationships.

  
  

A healthcare administrator reviewing financial reports for aging receivables.

Average Payment Turnaround Time: Understanding the Differences

Understanding payment turnaround times is crucial for managing expectations and ensuring financial stability in your practice. The average turnaround time for electronic claim submissions typically ranges from 7 to 21 days.

• Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT): Payment via ERA/EFT is normally faster, taking about 1 to 3 days.

• Paper Checks: In contrast, receiving payments through paper checks can take 2 to 4 weeks, which can significantly lag the cash flow you might require to keep your practice running smoothly.

  
  

This disparity necessitates a shift toward electronic methods of processing payments to minimize delays in receivables and improve financial health.

A desktop filled with medical billing paperwork and electronic devices for claim management.

The Complexity of Multiple Payment Portals

Today’s healthcare practices often deal with numerous payment portals such as Zelis, Optum Pay, Change Healthcare, PaySpan, and Availity. Each portal has its nuances, which can complicate the billing process. Here's how:

• Complex Interfaces: Different user interfaces can lead to confusion and errors in processing claims.

• Time-Consuming Management: Managing multiple platforms requires significant time and resources that could be better spent on patient care.

• Inconsistent Communication: Each portal may have different timelines and ways of communicating delays, causing misunderstandings and frustration.

  
  

Given these complexities, it is essential to have a streamlined method for managing these portals, a task that OneSource RCM excels at by simplifying the process.

A computer screen illustrating a healthcare billing portal for payments.

Impact of Delayed Receivables on Practice Operations

Delayed receivables can set off a chain reaction that affects multiple areas in a healthcare practice. Consider the various impacts:

• Cash Flow Issues: The inability to access timely funds can strain your practice, making it difficult to pay staff or invest in new technologies.

• Staffing Challenges: Unstable cash flow can lead to reduced staffing or delays in hiring much-needed personnel, impacting patient care and satisfaction.

• Poor Patient Care: When administrative staff are overwhelmed with billing concerns, the quality of patient care may suffer as attention is diverted from clinical tasks to financial issues.

  
  

In essence, a healthy practice relies on efficient receivables management, and neglecting this aspect can jeopardize the overall operation.

Rejection and Denial Issues

One of the most frequent issues fueling aging receivables is claim rejections and denials. Common culprits include:

• Missing Patient Information: If patient demographics are incomplete, claims are more likely to be rejected.

• Insurance Errors: Incorrect or outdated insurance policy details can lead to payment denials.

• Coding Errors: Inaccurate medical coding can prevent claims from being processed efficiently.

• Documentation Issues: Documentation that lacks necessary details may result in denial of claims.

  
  

Given the complexities surrounding these issues, how can OneSource RCM help reduce rejections and denials effectively?

How OneSource RCM Proactively Corrects Issues

OneSource RCM is adept at reducing the frequency of rejections and denials through proactive measures:

1. EFT/ERA Setup: Setting up Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) correctly is crucial. OneSource ensures that these systems are configured accurately to prevent future payment delays.

   
   

2. Portal Management: By consolidating multiple payment portals, OneSource streamlines the payment process, making it easier for your practice to manage claims.

   
   

3. Regular Training and Updates: The team regularly trains practice staff on billing best practices and keeps them updated with changes in coding and documentation requirements.

   
   

4. Comprehensive Audit Processes: Routine audits help identify areas of concern before they escalate, thereby preventing issues that contribute to aging receivables.

   
   

By addressing these common barriers, OneSource RCM not only reduces aging receivables but also enhances operational efficiency.

Best Practices for Portal Management

To maintain effective management of your billing portals, consider implementing these best practices:

• Centralized Logins: Utilize a centralized login system to monitor all payment portals from one place, reducing the risk of missing notifications.

• Assigned Responsibilities: Clearly outline who is responsible for each aspect of portal management to prevent any gaps in processing.

• Regular Checks: Schedule regular intervals for checking the status of claims and payments to catch any potential issues early.

• Documented Processes: Create a documented process for how to handle each portal, which can assist in onboarding new staff and provide clarity to existing team members.

  
  

Implementing these practices can help streamline your receivables process, allowing you to focus more on patient care rather than administrative burdens.

FAQ Section

Q1: How do I enroll for EFT/ERA?

You can typically enroll through your payer's website or contact their customer service for assistance.

Q2: What should I do if payments are missing?

Start by checking your portal for any discrepancies and contact your clearinghouse for clarification if necessary.

Q3: Can you help with portal consolidation?

Absolutely! OneSource RCM specializes in consolidating billing processes to improve efficiency and reduce aging receivables.

Glossary of Terms

• Aging Receivables: Accounts receivable not collected within a specified timeline.

• ERA: Electronic Remittance Advice, a document indicating how claims are settled.

• EFT: Electronic Funds Transfer, a digital transfer of money.

• Remittance: A payment of money, often for services rendered.

• Clearinghouse: An intermediary that facilitates the transfer of claims.

• Payment Portal: A digital platform for managing payments.

• Denial: A refusal by a payer to pay a claim for services.

• Rejection: A claim that cannot be processed due to errors or missing information.

  
  

Take Action to Improve Your Practice's Financial Health

Aging receivables, delayed payments, and the headache of portal challenges can severely impact your practice's operations. But there's good news: you don’t have to face these issues alone.

Contact OneSource RCM for a free receivables review or to learn about our RCM solutions. Streamline your processes today for better financial health and improved patient care!