payments for those still eligible. Unfortunately once a claim goes out of timely filing for follow-
up and payment it will need to be written off as a loss. Once that special project is completed we
will form an A/R only billing team which will break up to form smaller teams to work on
different insurances and self pay patients.
The benefits of timly and accurate billing is huge. By submitting a clean scrubbed accurate claim
on time, it will bring in revenue much quicker into the facility, Settlements with the insurance
can happen much quicker and have higher profit, a correct claim that is filed on time will have
less denials which now will take time to submit appeals and corrections. All processes of claim
management is important but our aging reports has many outstanding balances and attention
needs to be focused there to bring in revenue owed to the facility.
A strong EHR system with the capabilities to print detailed and specific A/R reports is essential.
This will make viewing and collecting the payments easier. A good clearinghouse is also
important for scrubbing the claim and ensuring it is clean for submission to carriers. A strong
billing and coding team, one with a strong follow-up team to ensure bills are being paid and
collected. The billing team will need to set a weekly billing submission and keep track of any
claims on hold or that bounce back due to issues.
Submitting a claim past an insurance's timely
filing limit will come back to you as Claim Adjustment Reason Code (CARC) 29 and state,
time limit for filing has expired."
CARC 29 has a high chance of prevention but a low overturn
rate. Simply put, it has a low chance of appeal
after you've received the denial
, thus you lose
money ( moneypenny,2019). We also make sure billers know the guidelines for timely filing