Healthcare revenue cycle management (RCM) is a complex process involving many steps, from verifying patient insurance coverage to submitting claims and following up on unpaid claims. Each step is important, but following up on unpaid claims is often overlooked, which can lead to significant financial losses for healthcare providers.
Why is it important to follow up on unpaid claims?
There are many reasons why it is important to follow up on unpaid claims. First, it helps to ensure that healthcare providers receive the reimbursement they are entitled to. Second, it helps to reduce the amount of time that providers have to wait for payment, which can improve their cash flow. Third, it helps to prevent claims from being denied or written off, which can save providers money in the long run.
What are the consequences of not following up on unpaid claims?
There are a number of consequences that can occur if healthcare providers do not follow up on unpaid claims. First, they may lose out on significant revenue. Industry estimates suggest that healthcare providers lose an average of 25% of their revenue due to unpaid claims. Second, providers may have to wait longer for payment, which can lead to cash flow problems. Third, providers may have to write off more claims, which can further reduce their revenue.
How to improve follow-up on unpaid claims
There are a number of things that healthcare providers can do to improve their follow-up on unpaid claims. First, they should have a system in place for tracking the status of all claims. This will help to identify claims that have not been paid on time. Second, providers should follow up on unpaid claims promptly. It is important to follow up with insurance companies within 10 days of submitting a claim. If a claim is not paid within 30 days, providers should follow up again. Third, providers should be persistent in following up on unpaid claims. It may be necessary to follow up with insurance companies multiple times before a claim is paid.
Here are some additional tips for improving follow-up on unpaid claims:
Use a claims tracking software to automate the process of identifying and following up on unpaid claims.
Assign a dedicated team to follow up on unpaid claims.
Develop a follow-up process that includes clear timelines and escalation procedures.
Be proactive in following up with insurance companies. Don't wait for them to contact you.
Be persistent in your follow-up efforts.
By following these tips, healthcare providers can improve their follow-up on unpaid claims and reduce the financial losses associated with them.