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The Harsh Realities of A/R Follow-Up

by Ahmad Jawad, on Feb 18, 2019 7:53:04 AM

Has your team ever been blamed for struggles in A/R follow-up?

The revenue cycle industry has been conditioned to point the finger of blame at itself for the challenges in A/R follow-up.   

Our industry has also been trained to believe that cleaner claims ensure accurate and timely payments. 

However, MiddleGate's Grace has found that many A/R issues can be attributed  to unfair Payer patterns and trends.
(See Fig. 1, Fig. 2 below):

Note: Green/flat is normal and Grace is happy with the Payers. Red/orange means Grace is angry with the Payers.

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 (Fig. 1 above) Medicare behavior.  Relatively flat, normal behavior across all categories.

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 (Fig. 2 above) Commercial Payer XYZ's behavior. Note the changing and shifting patterns over time. Grace discovered that this Payer is withholding payments for a specific set of codes.

Payers leave a trail of patterns in revenue cycle and Grace is obsessed with patterns

Topics:Machine IntelligenceRevenue Cycle ManagementArtificial Intelligence

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MiddleGate delivers technology solutions to improve revenue cycle management. Get the latest updates on our blog where we aim to deliver relevant, cutting edge news and commentary on technology issues within medical billing and RCM. 

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