Question

imagine that you are an office administrator in a physician’s office that supports four doctors. Reimbursement from various payers make up the payer mix that can be viewed in the form of an aging schedule. The aging schedule informs management of the dollar amount of revenue that has been generated in the current month and what revenue has yet to be collected from previous months by each payer.

While reviewing the processes surrounding the revenue cycle, you have determined that improvements are needed in front office processing. Describe one improvement that you would recommend implementing in the front office staff as it relates to processes with the revenue cycle.

Answer 1

The front office shall define cut off outstanding days after which follow up becomes necessary. That is, if the outstanding is due for 120 days or above, the staff needs to initiate strict follow up measures in order to recover the money and ensure that no further treatment is offered without any partial/full recovery from the patient.

Plus, there should be a clear segregation between dues which are recoverable from patients directly and dues recoverable from insurer of the patient so that in case the dues are outstanding from the insurer from 120 days or more there is a possibility that the insurer did not pay the clinic on the grounds that the treatment offered was excluded from the policy and in such cases the prompt measures can be taken for recovery from patient.