Know your payers
Understanding payer mix helps better manage collections. For example, Medicare commonly pays within 14 days, but worker’s compensation claims can take 45 to 90 days.
Increase collections and reduce days in A/R with integrated PM
Your medical practice deserves to be paid fully for the services it provides. Practice management should incorporate tools to promote cash collections and minimize days in A/R—such as claims editing, streamlined workflow, easy patient pay, and financial analytics.
Uses and benefits of our technology
Increase payments from insurers and patients
Every year practices lose revenue by failing to collect total payment for services. Boost revenue from both third-party payers and patients with support from our technology—such as claims editing software, a rules engine, a cost-estimator, self-pay solutions, and more.
Edit encounters prior to claims creation
Clean claims help avoid denials. NextGen In-line Edits provides for automated edits and real-time edits of encounters prior to claim creation. You can to quickly correct issues within the encounter, which helps to accelerate cash flow and reduce claim denials.
Correct charge data for faster payment
Implement a rules engine that uses custom and specialty-specific rules along with automation to review and correct charge data before it enters the PM system—eliminating 75% of the tedium of charge review. This can help speed up collections.
Follow up on denials
As part of A/R recovery, follow up on denials. If a high percentage of denials are related to the same error, look for a practice management solution with a rules engine that can be updated to avoid recurring denials.
Make it easy for patients to pay
Our cost estimator makes it easier to identify the patient’s responsibility and collect payment upfront. Access to a patient portal and flexible, online payment options make it easier for patients to pay and helps speed up collections.
Use analytics to understand denial trends
Uncover your most common reasons for denials—coding errors, errors in patient demographics, failure to obtain preauthorization, noncoverage by the insurance plan, lack of medical necessity, or other possible reasons. Understanding denial trends can help improve policies and educate staff.
Strengthen your revenue through practice management services
Use financial analytics
Financial analytics can help you understand your practice’s A/R trends and uncover underlying reasons for increases in days in A/R. Use analytics to make informed decisions.
Automate and streamline
Your practice management system should enable you to automate key tasks and streamline workflow for patient billing, A/R management, collections, and reporting.
Meet deadlines
Payers have specific deadlines to submit claims—timely filing limits. If a claim is denied because you missed this deadline, you have no appeal rights.
Appeal denials
Appealing denials is part of A/R recovery. For Medicare denials, you may resubmit the claim to CMS. Commercial insurers have an internal appeal process.
Estimate patient pay
By the time the patient walks in the door, it’s critical to know how much they are responsible to pay. Implement a cost estimation tool.
RELATED CONTENT
Learn more about collections and A/R management
The results speak for themselves
Our award-winning healthcare IT solutions become better each year thanks to the tireless efforts and ingenuity of our diverse team and insightful feedback from medical practices like yours.
READY TO UPGRADE YOUR PRACTICE?
Make the switch to NextGen Healthcare