Accounts Receivable Management

Claims Management 

  • in-house certified professional billers and coders
  • electronic web-based claims processing 
  • paper claims processing when necessary
  • well versed in many software systems
  • payment posting
  • claims processed EVERY day. 
  • Account coordinators assigned specifically to your organization’s account
  • Consistent communication with providers regarding claims status and management

Denial Management
Money waiting to be collected is revenue loss!

Denials are an epidemic to the financial health of most practices, and they have a need to be treated well in order to get you financial success. In fact, overall claim denials are on the rise requiring more time from your back office. Over the years, payers have created more barriers to getting paid and we in healthcare, have agrees to those new payer contracts. Years ago, claims were reviewed, processed and paid by individual claim processors. Today, much of that work is determined by the computer. For some payers, it seems that the algorithm is “when in doubt, deny it.” In addition, payers are expecting that only a small percentage of medical practices will follow up on claims denials and resubmit them corrected or as appeals. Essentially, denying your claims save the payer money. This is why outsourcing your claims to a medical billing company can be beneficial. 

Our billers believe that athe ccuracy of the claim and the time spent on retrieving the payment are key points in optimized revenue collections. Our aim is to improve the client’s cash flow by reducing days in accounts receivable and improving profitability, by increasing collections ratio.

Our billers identify category/payer combinations and work on resolving the mix that results in the best collections.  They organize the Account Receivables timeline wise (AR days between 30 to 45 days, 45 days to 60 days and beyond 60 days)and work on critical claims first.

Our billers are experts in denial management analysis and taking necessary action to collect unpaid and partially paid claims. Our expert billers have helped medical practices that essentially have a back office nightmare of elevated accounts receivable and denials and turned them in the right direction. 

Our billers are trained to recover collectables from:

  • Worker’s compensation
  • Medicare
  • Medicaid
  • Private insurance
  • Attorneys

We work closely with our clients and their medical providers on a daily basis.  Our account coordinators keep a consistent working relationship and communication with providers to create the most seamless effective claim process.  This, in turn, maximizes the financial health of the client’s business.

Appeals Management

Denial claims also require “Appeals” – Appeals are requests and explanation of the claim sent earlier and conditions on which the claim now is again eligible for payment.

Some appeals are time sensitive. Our Billers review your most commonly denied claims, prioritizing both for volume and dollar value and file them in a timely manner. Considering the cost of appealing claims (both in terms of time and money) also helps our billers decide whether they must appeal the claim at all. So they will not appeal every claim but know the fact that many practices lose great sums of income every year because they don’t appeal denied claims.

Patient Responsibility Management

Patient financial responsibility is up 11 percent, according to the most recent data from TransUnion Healthcare. The average person is now paying $1,813 in out-of-pocket costs a year for their healthcare services.

We know that increasing patient responsibility can add stress to the patient and the medical provider.

We are here for both, the providers and the patient and do our best to “bridge the gap” to keep the overall patient experience a positive one.

At SYFR, we understand the patient’s the medical billing process can be overwhelming on top of the dealing with the medical issues themselves. Our professionals have compassion for the patients as well and like to assist and educate as well.  We explain to them how to read their bill, how to understand an EOB and the process between provider, insurance and us. We can help patient’s set-up payment plans that make sense to the patient and the provider.