Challenges in Meeting OIG Requirements
The OIG has specified time limits for AR follow-up that are based on the balance and the age of a claim. However, due to technology and staffing limitations, it can be difficult for the VHA to meet those requirements. This is especially true for the high volume of claims under $250.
The most common problem for VHA facilities is simply a lack of trained staff. Even at facilities that are able to maintain a large number of staff dedicated to AR follow-up, that staff is compensated with a regular salary. Compensation is paid regardless of results, which can negatively impact motivation. And often it’s just not possible to continuously monitor the staff.
In addition, VistA is not built specifically for revenue recovery operations.
The end result is that a significant number of claims that could yield revenue are not processed appropriately.
Achieving Your Performance Goals
Benefit Recovery continually exceeds OIG follow-up requirements. The very experienced AR follow-up specialists at Benefit Recovery are rigorously trained, well supervised, and meticulously audited. Our unique team and mentoring approaches ensure that best practices are adopted rapidly and adhered to thoroughly.
Perhaps most importantly, our specialists’ compensation is tied to the results they achieve for you. That’s one of the main reasons Benefit Recovery consistently outperforms the industry.
Another is our superior technology. Over the past two decades Benefit Recovery has developed and perfected highly focused software systems that allow our specialists to resolve a much greater volume of claims than is possible with even the best healthcare financial management systems. We easily establish follow-up rules in the software that ensure our staff employs the most effective strategies. Through numerous similar innovations our technology has become a very powerful compliment to VistA’s capabilities.
The result is more claims processed at a lower cost per claim.
A substantial portion of your revenue comes from first-party sources. Benefit Recovery offers a First-Party Follow-Up service that is in strict compliance with OIG guidelines and procedures.
For First-Party revenue this includes:
- First Party Repayment plans
- First-Party waivers
- First-Party Claims matching revenue/transactions
With Benefit Recovery AR Follow-Up you’ll achieve these important objectives:
- Improve cash collections against goal
- Reduce cost to collect
- Reduce Gross Days Revenue Outstanding (GDRO)
- Identification of trends for internal process improvement
- Detailed and customized reporting on demand