At Promaestro, we believe that effective Insurance Follow up and A/R (Account Receivables) Management are the most important areas to ensure optimum revenue recovery, accelerate revenues and increase cash flow. Lost revenue due to denials averages between 6% and 10% of net revenue nationwide. We have a proven track record to enhance the financial health of our clients.

Need for Insurance Follow-up

Consider the following facts:

  • 14% of all claims submitted to payers are denied and have to be resubmitted, appealed or written off by Providers.
  • 50% of denied claims are never re-filed.
  • 90% of denials are preventable.
  • 50-70% of denied claims are recoverable.

This can cost your clinic or practice thousands of dollars every year. Aside from the direct impact from the loss of revenue, there's an additional impact on resources because of the expense associated with reprocessing denied claims.

The reasons for this state of affairs are not hard to see:

  • No motivation on the part of billing staff to do adequate follow-up
  • Inadequate training in follow-up procedures
  • Billing staff turnover
  • Lack of time for effective insurance follow-up
  • Physicians do not get timely and accurate reports needed to properly monitor aging accounts.
  • Expensive resources focus on high value claims alone.

Our A/R Management Approach:

  • A/R Reasons and Resolutions: We at Promaestro scrutinize the aged ARs for reasons and resolutions. Our specialized team does all that has to be done to bring back your aged AR lucratively. We are well aware of the nitty-gritty of the process, that's why our hit rate is stern at 100%.
  • A/R Scrutiny:  We have individual teams to dissect the 'new' and 'old' ARs separately. We slice up and chase the ARs based on the schedule and dexterity of the payments. We do all these activities paying heed to the evolving rules and regulations from the payers and other federal laws.
  • A/R Hunt:  We have strict follow-up methodologies to closely chase the ARs from the payers. We pay strict attention of the impediments, denials and re-submissions and end up only with a thriving collection.

Our Strategy for Insurance Follow-up:

We use technology and people skills to follow up with the payers to identify, address and rectify the identified problem.

  • Identify accounts that require Insurance follow-up with the Payers
  • Account Receivables analysis with respect to aging and filing/appeal limits of the various payers
  • Focus on those low-value, low-margin accounts that make it difficult for you to profitably recover your revenues.
  • Define strategy and process to maximize recovery. This includes identification of difficult accounts and transferring ownership of those select accounts to a specialized team of experts.
  • Use all suitable channels of communication for follow-up. This includes web, phone, email and fax.
  • Even if you and / or your current billing company have written off large amounts of Insurance AR (Account Receivable) balances as unrecoverable, contact us today to determine how Promaestro can help you to recover lost revenues.

Our Follow-up Plan:

The priority of the claims follow-up will be based on the followin

High Dollar high age - These claims would be processed on priority as the claims need to be followed up before we exceed the filing limit.

High Dollar low age - Next focus would be on high dollar claims with low age as the chances of collection are higher.

Low Dollar low age -These claims have higher probability of collection. However, need many more resources to follow-up

Low Dollar high age - These claims are given last priority as these claims have less chances of collection and need high number of resources to follow-up.

Key Differentiators of our Insurance Follow-up Services:

  • Your revenue cycle is accelerated
  • Your practice experiences improved cash flow
  • Your aging Account Receivable balances go down
  • You experience improved collection ratios
  • You are insulated from staff turnover issue
  • Your expensive and trained staff focuses on auditing and patient collections
  • Your administrative costs are lowered

We present weekly and monthly reports on A/R collections, concerns and the recommended remedy. We are trained well enough to get you out of your most niggling aged A/R !