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[Music] thank you [Music] [Music] questions [Music] foreign foreign [Music] [Music] [Music] thank you [Music] thank you [Music] foreign [Music] [Music] hello Hello friends happy Friday Eve welcome to Medical Builders Network Live I am Jasmine Villiers and I am over here um just trying to there we go she put it in I was like oh no I need to download something thank you Nicole um all right so um today we are talking about accounts receivables um I love that you guys were excited about this conversation we have a lot of hi Angel's Mom hi Marcy great to see you guys um and Angel's Mom it says I love that um so uh so tonight what I love that you guys are excited about this topic it's actually one of the um things the topics near and dear to my heart we'll call it um because it's um kind of like the the thing I got most excited about when I started billing um was really digging deep into the AR and those of us hi Arissa hi Mohammed hello hello good evening um so you know it's one of those things that that has kind of spoken to me all of my career as um as one of the languages that I learned and feel very comfortable in So today we're gonna talk a little bit of a broad stroke because we're going to start talking about accounts receivable or topics related to accounts receivable for the next few weeks but um I wanted to because you guys have asked a lot of questions number one um and I really wanted to to answer some of the the general questions about the what the why um so if you have specific questions um hi Packy Gamers hi Facebook user your name I'm sorry um but if you have specific questions that you want to have addressed if you haven't been here on a Thursday recently what we've been doing for Medical Village Network Live is following a little or Jasmine I'll say following a bit of structure um Loosely stated because um we are trying to make sure hey it's Susan hey Susan um we are trying to make sure that we have um opportunity to do q a at the end so the beginning we're going to have a little bit of teaching I'll talk a little bit today I'm not going to um do a presentation for the entire teaching I am going to pop a screen share SlideShare up here for just a second but during the teaching portion it'll be more dialogue based so if you have questions or things that come up during it please or comments editions especially my billers um practice managers other folks here that have lots to add to this conversation of things that work or don't work I'd love to see your comments as I'm speaking through stuff and then questions like flood the comments with as many questions that you have coming up because even if it's something that I feel like is kind of a I hate the word to use the phrase loaded question but like basically if it feels like it's going to need a lot of context or examples I will might take that and reserve it for a whole separate discussion um but I would love to tackle questions that are going to be really good clarifying questions about um accounts receivable or what to do when to do those kinds of things so with that said um while you guys are saying hello keep saying hey let me know you're there telling me that um you are logged in and maybe I think our question of the day today is uh what are your AR questions so our question is a question so there you go there's your question of the day um so here is our weekly Roundup so last week we had our trivia party and all right so I think that it is official that Carrie and Nicole are going to have to be our trivia host because it like no I don't know how this is possible but absolutely for like the third month in a row totally unplanned and I had something come up that led me to not have to um to be able to be available for that live stream on Thursday so thank you so much to Carrie and Nicole if you guys can like give them like shout outs and high fives in the um in the Facebook group just to show them how much you love them for still showing up because if they're up to Jasmine I would have said yes to my emergencies and probably not hosted so if you totally asked so I don't want to be that person though so um so this is why we have these lovely ladies helping and making sure that we still can do our our trivia party and um we did have two fantastic winners last week there were new winners I think they hadn't won they hadn't played even previously so I'm excited about that so hey Tyra hey Marcy all right so um trivia is every first Thursday of the month so if you have not participated in trivia Thursdays come back it is revenue cycle Focus so it kind of runs the gamut of the topic so we're medical billing coding um even some front-end questions even back-end questions so be prepared learn something share your knowledge invite your friends to play along we have been doing Amazon gift cards so it's free money for like typically 25 30 minutes of your time so why not and it's fun it's trivia everybody loves trivia um so before that we talked about the best apps for process creation I love process I hope that you guys like process I'm not gonna say you love it yet but we're gonna make I'm Gonna Make You Gonna help you be inspired and get fall in love with process hopefully and and value it so um so today we're talking about understanding accounts receivable or ar um and so stick around we'll talk more about that after I share about courses so if you're new here uh welcome this is in Larry University specifically Thursdays we are medical billers Network live where it's a band fillers group set group of individuals that get together with the commitment to help bring forth change improvements and hopefully delivery improve the delivery of our Patient Care by alleviating all the mess and confusion that we all find on the billing side of healthcare so with that said if you are new to this community and don't know what I'm talking about but you're interested in Billing stick around watch our other videos because this is absolutely the community for you if you're interested in getting into the business side of healthcare if you know that you like it and you want to learn something a little bit more formal we you have courses I've got some self-paced courses a couple that are on the screen right now that are billing related they're both included in a bundle for someone who's like brand spanking new so I'm not going to go too far into that detail but just no one's a it's a one-on-one level meaning like you don't have any knowledge and you really just need a taste of like what the heck you know what is what is this concept of medical billing even if you're not interested for saying going into the field but need to understand it because you yourself are a patient or a caretaker for someone else the language of billing is great for someone who is interested in the field or someone who is working kind of in an adjunct area so maybe you are on a clinic on the clinical side and you need to interface with the billing team a lot um or maybe you're on the front end or even on the scheduling team but you need to understand so you can have a really meaningful conversation language of building is very very helpful so as I said that's part of the bundle so check that out and at some point we'll have the link put in there so you guys know where that where to go to look at these courses and offerings it'll be somewhere on these Gadgets in um on the device that you're watching on um so Medical Village terminology medical billing excuse me medical terminology for billing and coding is a course that um that is devoted to really helping you understand or have a foundation for a medical terminology it's the just that so if you are interested in just expanding your knowledge for the sake of like helping to craft more meaningful appeal letters or have real conversations with the provider about clinical terms and not feel confused by what they're saying or even just reading the documentation when you're trying to to um to see what was done with the patient so medical office reception is a course that is made for someone who is interested in working in healthcare like from scratch like honestly brand spanking new you don't know what you want to do what you want to where you want to go this is a perfect entry level position for you um if you're not sure you want to get deep into medical billing then start off with the office reception course because it will give you a great foundation for learning what you need to learn for working in a crack in the medical practice um so our instructor-led program this is our full meet program one that is geared towards individuals really wanting to really deeply understand medical billing to be a very uh we'll say masterful Builder someone who knows what they're doing very confident and really on the track the fast track for potentially a place in like next level right so being a an account lead being an accounts manager then maybe to the next level supervisor those kinds of things because these these folks are going to be learning directly from individuals like myself who have been doing this billing world and oversight management for many many many years and we know what works and what you should know to be considered an expert in the field uh we start on March 27 50 and see the date down there um and then we have our CPU Readiness which actually was scheduled to start this week we have uh we have an opportunity if you have not um joined and you would like to to still continue to jump into that course you would just need to make sure that you instead ideally get an ebook version of the cpb um manual from the aapc in order to to kind of jump into it quicker because I think they do have a fast shipping on the book but it's pretty pricey so it'd be easier for you just to grab it um on an ebook so uh any questions about any of the courses please pop that into this the comments before after during this live stream and I think we're ready to go today we're talking about accounts receivable so accounts receivable pop it away all right so AR whenever people use this term AR typically we are referring to accounts receivable but some people are used to uh the term that is often used to explain an aged receivables report which is a specific type of accounts receivable report so we'll talk about that in a future session actually I think there is a video already um and Nicole will task you with that little note if you could just jot that down um we can link it somewhere in the um description box below that you guys can watch so you understand there is a slight difference between the age receivables versus um a typical accounts receivable report we'll talk a little bit broad stroke about it today and then I love going over AR or account achievable report examples with you guys so that's going to be a later date but I'd love to to look at um or I know what you guys are struggling with and trying to understand whether you should use one over the other because that really is what what what is down to is it useful for you right so when we say AR the term AR is actually stands for accounts receivables now aged receivables and accounts receivables are are are it's almost um not exactly the same but an age receivable report is a child we'll say or like a product of an accounts receivable so accounts receivable is very simple is money that is waiting to be received okay so it's money that is waiting to be received by either the health care practice or the organization so when we say accounts receivable it think about it if it how if it helps to remember it this way it's money that has been generated because the patients were treated and now we're waiting to receive the value so it's um the the visits have been have taken place and the value for those visits the reimbursement for those visits we're waiting to actually receive okay so what does that mean it means that winning in healthcare most of our health care is not cash based right so patient comes in patient does not pay cash the majority of the time if that happened self-pay patients pay out of pocket a hundred percent of the services are that were rendered or paid by the patient there is no accounts receivable because visit happened patient paid the same day okay so when a person is self-payed just intrinsically there is no such thing as the accounts receivable because the patient was treated and the money came in the same day okay so there's not a waiting period for us to receive the money when we're saying accounts receivable we are hoping to receive reimbursement from either the patient or the insurance after the visit we're waiting to receive that payment there is another term that's often used in accounting that's accounts payable which is exactly the opposite it's we're waiting to pay someone for something that has taken place okay so accounts receivable is money that we are trying to bring into the organization or the practice for services that were rendered okay so really important that you're clear about the differences there now when we say aged receivables why I say they're almost they're they're often used in it almost more synonymously but they're not synonymous really when we say age receivables those that is the clock associated with the accounts receivable right so when I said I'm waiting to receive the money patient has left the office the next day so today is Thursday patients left Friday the next day my accounts receivable has now aged and now it is considered an aged receivable okay and now that will appear with one day sitting in my accounts receivable okay so now my days in AR which will talk way deep about metrics I love these RCM metrics or revenue cycle man uh management metrics because it's valuable for us to understand but you have to understand why we use these terms and what they really mean a lot of us are so used to saying things and don't understand the basis and deep constantly digging deeper is what is going to help you feel more confident in your job and it's also going to bring more value to the organization okay it's so important that you can have deep knowledge and deep understanding of these topics that you're spending I don't know most of us are spending 60 to 70 of our lives at work okay doing this so if you if you don't understand what you're doing from day to day more deeply every day that goes by then you know what are we building a successful career or are we just kind of dabbling right okay so when we say aged receivables or we say something is aging those days that are going it's a number of the number of days or the time frame that is going by that we're waiting for that money to come in okay so aged receivables is like a child of an accounts receivable because it is something that really gives a specific time frame or a clock associated with your accounts receivables okay accounts receivables in the broad stroke of it the whole accounts for people's report is a is a mush of everything the way we put order to it is by giving them aging dates because it could like I said tomorrow one day is is accounts receivables I don't care as much about that one day as I care about something that's 31 days old okay I care way more about what is happening with my thing my patient claim that is 31 days old and the the the data service that just happened a day ago not as important to me because that data service I'm hoping is going to be paid within the next seven to ten days which is the typical turnaround time to receive reimbursement these days um so if you have questions about that please let me know I want to know that you understand does that seem clear do you have any thing that's still lingering there about what is the difference between an accounts receivables report and an age receivables and is that clear does it feel clear because I I get this question so much and I really want to make sure that everybody is like really getting it so let me know let me know in the comments pretty please okay so is AR a bad thing I get also this question these are some things that I really want you to know about AR or an accounts receivables the entire concept it is not a bad thing as you just heard me explain when when you have a patient that has a claim that was generated it automatically starts to be pending on our accounts receivables report what that means is we now have a value associated with money or cash flow that's going to come into the organization okay that is a positive thing if you have an accounts receivable report that is zero I am worried because that means that you have no money coming into the organization there's no plan for you to actually be receiving money for visits that were had taken place so an example of that is if a doctor goes if you have a solo provider practice or clinician practice and that provider goes on vacation for an extended period three weeks four weeks and you have not seen a single patient during that period you might start to have a dwindling accounts receivable report which means that you now are going to see a plummeting of your clock left a plummeting of your cash flow which means you're not going to receive any money for a period probably an equal period to the time frame that the doctor was gone you might be two to three weeks without much um coming into the door so it is not a bad thing to have an account receivable because it means that there is money that's going to be flowing into the organization okay so I hope that helps most people are like oh my AR's you know my AR is Big I'm okay with your AR if it's big and it's less than 30 days like I'm okay with that let it be big let it be 90 of your Asian of your account stable reporter your age is sitting in that that zero to Thirty happy with that so happy with that all right so um let's see why do we care about the size of an account streamable report number one is that once things get beyond that first aging bucket as we were talking about like over 30 days it gets harder and harder for claims to actually be paid it gets harder and harder for us to collect that same is true for patients and for the prac the insurances as well okay because yes I know that there are some carriers that take a while and there's some things that go on but the bottom line is that once something is old especially if it's billed to a patient and they've ignored it a lot um it's likely that they're just not going to pay it okay so as something gets older and it's out of sight out of mind if you hadn't sent them a statement and they hadn't been in for uh in for a while um you're probably not going to see that money so we want to make sure that we are tackling it as quickly as possible to make sure that we are really being proactive okay and so um when we say the AR is bad I gave a couple of examples of what could be a case for worrying and that's over 30 days now that is not a rule it is going to be dependent upon your practice and I say that because if 99 of your insurance carriers pay Within seven to ten business days or ten business days then you might be actually thinking that anything past 20 days or 15 days even would be considered poor or bad and we need to start tackling or following up on those claims right away okay so if your days in AR like I said that I gave you as a that phrase earlier that's the number of days that that particular claim is sitting on your accounts receivables report the number of days that the claim is waiting to be paid or we're waiting to receive those funds okay if that is within a period that I lost the thought that was like really at the Forefront of my mind so I'm going to just recreate this example it just went poof the middle sometimes that has uh it is the end of the business day um okay so what I was going to say it was like it was there but what I think I was going to say I should say is um is that the accounts receivable um the days and error where the heck was I I'm looking at my notes okay I think I was gonna say this basically when you have a um a an aging uh days in AR for your practice and you've determined your days in AR um is is on average as my example earlier 10 days like that's how long the claim sits in there before the payment actually comes in the door then you're probably gonna start really trying to tackle anything that goes beyond that right so determining your days in AR for your practice is important because my practice might be doing things in the Stone Age and getting claims on paper out the door and then um paper checks coming in and you know things that are just running so much slower so my days in AR might be more like 25 five days so I'm really thinking like maybe 30 days or more was what I'm really thinking about I'm not touching anything before then okay that is not an uncommon Practice still unfortunately it is quite a common practice that people will say like we typically have to wait 20 days or 25 days or whatever for checks to be deposited for payments to be made now if if you have gotten your revenue cycle tight tight tight you're probably a lot faster than that so you can look at bad being anything that's above 20 days okay um I I like to say like and when you give billers like number of days it gets confusing because we always use we typically are talking in business days so um instead I actually like to say weeks so just say three weeks that's you know 21 days 21 calendar days so if you say three weeks it usually helps people wrap their head around it because they can just go to a calendar and count back instead of like trying to subtract a number of days it can be mind-bending for some people so um so yeah so AR is not bad remember air is not Arizona determine what bad ner so that's really important that you sit down with your accounts you will report look at how quickly insurance carriers are taking to pay on average and then deciding like which what should I be focused on all right and so let's now talk specific things about I'm going to give you five tips today about accounts receivable things that I um think are the absolute most important thing if you have not really tackled this topic of accounts doable or you're trying to kind of hi Larissa great to see you um if you haven't really decided um how to formulate any kind of approach to accounts receivable this is going to be a really great um I think kind of high level tips for you and what I want to know is like what's working for you if you've already gotten your stuff down is it something you're trying are there things that I'm missing in my list that you want to add to a list so again I don't think I'm the expert I want you guys to add value to this conversation so I want this to be a network us together all right I'm gonna constantly be saying that because it's very very important to me that you guys know that this is not meant to be a Jasmine on display for all of her knowledge I I don't pretend to know everything all right I do not I know a lot of things a lot of random things that most people outside of Health Care don't give a crap about but but I love when I get to learn something new and I want to learn from you guys all right so um so number one so tip number one is not I mentioned this earlier it is starting by preventing things getting on your accounts you will report right which means optimizing your revenue cycle if you are here this whole channel is devoted to optimizing your revenue cycle the whole thing even even when we talk about credentialing that is still optimizing your revenue cycle because most of us know your provider's not credentialed it holds a whole whole host of issues that impacts our patients so you must must think about ways to improve or make sure your revenue cycle is as tight as it could possibly be what more could you do to make it work more smoothly what can you do to make sure that the claims go out faster what can you do to make sure your providers are closing out their documentation even if it just means a conversation that you have to have 20 times until you're purple in the face um not just blue but purple um that you are trying to get your providers to close out those notes so that you can close finalize the claim and get it out the door what can you do to make sure that your rejections are worked faster okay there's all of these things that again start at the top of our revenue cycle and move around that impacts the entire the possibility that the money can be considered as waiting to be received okay you got to think about the entire revenue cycle because all of these things that they can get be roadblocks to actually getting your claim paid and resolved okay you do not try to focus attention and effort to getting the claim um as clean as possible to make sure that you have the right information all of these things that could potentially land this particular claim on your AR report and now you're bad tracking trying to figure out what went how what would happen What would happen what went wrong I'm making up sentences over here um yeah so what went wrong with your claim so really really think about how do I optimize so that was tip number one how do I optimize my revenue cycle what can I do to reduce the number of days in age out in a in AR and that might be working in your Clearinghouse that might be making sure whoever is working your rejections is really focused on resolution as quick as possible and also focused on prevention like nothing pains me more than when I see someone doing the exact same fixes over and over and over again to a claim that could be prevented by adding a modifier in a setting in your software you got manual intervention happening in the Clearinghouse that shouldn't be there okay so very very important to think about ways to prevent all right number two is just uncovering the right report for you make sure that you are looking at all of the possible reports available in your software don't just go with the one that you happened across the first time like keep digging ask questions to your support hopefully have support go on to Facebook groups or whatever group your particular software company has there's there's a lot of Facebook groups out there for for um practice management software so I would I would urge you to try to get in touch with other individuals you can put it in our Facebook group ask other individuals what are you using for your report what are you using to follow up on your claims what report because sometimes people have software companies have these reports that say accounts receivable reports but they are not useful because you can't Resort it and you can't organize it and you can't omit things that are less than 30 days like there are a lot of um caveats to to the to those reports and opportunities for you to like find something that is more useful is going to be the thing that will help you the absolute most in your job um okay so when you're talking about accountable reports there's a couple of different types of reports that I will also urge you to look into I mentioned about the Aging report so perhaps your software has an age receivables report or an aging report that might just very generally be called Aging report that you can isolate to only show you things that have a certain age so things that are older than x number of days right or older than um X number of days I don't think of the number of days my brain is tired today I guess um the other other thing I would also there's other report names that I've seen very often very common in other software is an outstanding claims report that sometimes has an aging opportunity in it so you can go to an outstanding sales report that has like perhaps a filter on it that says give me all of my outstanding claims my claims that have not been paid yet that are older than x days okay so outstanding claims report is another potential report that you could look for and again don't go by just what Jasmine is saying I would absolutely urge you talk to someone with your software put it into Facebook groups try to get some answers all right um number three so create a strategy for working your report where we'll talk a lot about strategy and aging reports because this topic is kind of there's a lot of ways to slice it okay there's a lot of ways to slice it I have there's there are ways to adjust based on size of your practice the size of the actual report but it's really important that you understand the different approaches that each of us use because your situation is probably going to be very unique to your practice okay so you might take a sample from what Jasmine says a sample from what Nicole says from what Carrie says of sugarcoat has a lot of value to add to this conversation um so there's a lot of a lot of people that you might sample from and say I'm gonna take a small percentage from each and then I'm going to add what I think and that's my perfect concoction for a strategy for how to work my AR report from my practice okay so it's there isn't one only one way there are great ways a great methods and it's important that you learn what everybody else's great methods are so that you can figure out the best approach for your scenario and why is it I say there's no there's not one way main reason is because sometimes it's a volume thing sometimes you just have a you know you might have a ton of providers you might have a ton of procedure codes that are done in your particular practice meaning like you know six to eight line items for each particular data service and you got patients coming in like therapy practices or physical therapy or Behavioral Health Service practices sometimes those guys have a lot of line items that come out so you end up with these you know massive Sports because you just have patients that are coming in so frequently and it just grows and grows and grows so your approach can be different than someone who's got a solo provider practice that is like you know sees a therap a mental health provider that sees like you know 10 patients a week or something that is a completely different approach to someone that has you know a massive therapy practice that you know has over 200 visits happening in a day okay I said massive at 200 is maybe not massive for a large practice it's probably more like 500 depending on the number of providers but um but okay so um that was number three creating a strategy number four is monitoring your aging buckets and learning what averages for you what is the average number excuse me percentage in each of your buckets that you have maintained on a consistent basis and then how do we just slightly tune turn down the ones that are higher right so if we're talking about over 120 if you're you know 60 in over 120 how do we take that just to tick down from 60 to 55. how do we take that down to 50. what's the plan to move it down so thinking about ways of short smaller excuse me targets for yourself instead of saying I'm going to get that down to zero it's going to be amazing and just like disappoint yourself so thinking about ways that you can slow make smaller improvements to each bucket month over month yes you want you looking at these every single month without fail every single month your aging buckets you should be monitoring them and ideally the same time every month so if you generate your aging buckets on the first Monday I don't like to say the first because sometimes the first is a Saturday on the first Monday of every month or the first Wednesday or whatever day that works best for your schedule pull it the same day every month so that you can get a sense for what it looks like on this typical frequency every four week period or whatever it is for your practice to make sure that you have an understanding of what is average what are the numbers that you're you're typically seeing and is it improving is it improving or is it now going in the opposite direction and worsening so very important to start to evaluate the numbers monitor them on a regular basis so that you can learn what is working if something your strategy that you have picked is it working is my strategy working if it's not what do I need to do what adjustments can I make who do I need to talk to what does jasmine say that I could do okay like the There's an opportunity for you to now be able to say okay tried that didn't go in the right direction what can I do now right so keep a very close eye on it I actually would recommend that you'd literally take those buckets and plug them into an Excel or a Google sheet y'all know I'm Google put them into you in a Google sheet and say this is March 2023 here's my Asian buckets this is April 2023 here's my agent buckets there are there's arguments that say you need insurance separate from patient I see cases for both I'm going to just say it depends on your practice if you're um an ambulance company like heck yeah it's gonna be a mess if you try to keep them both the same right because patients you're gonna have money sitting in your aging report from patients forever and a day some cases so it's important for you to separate them segment them but if you are a practice who sees mostly Medicaid don't waste your time like don't waste your time trying to segment or parse out a report because majority of your reimbursments are coming from the insurances not your patients so again this is a situation where you need to make the best decision for your practice all right um so make the adjustments monitor it month over month so that you can make the adjustments my last tip is one that most people ignore it is when it's done it's done just call it write it off if it needs to be written off write it off because if you leave these stale bad debts sitting on your agent report it just makes it that much harder to understand what is actually possible value cash that can be received in your practice if you leave it just sitting there it's just going to get old and messy and you're not going to be able to understand whether it's something that is reimbursable or not okay so if it's a timely filing denial you do what the whatever is allowed for your insurance carrier if you're allowed to appeal and you got proof for it cool do it if you don't you gotta just check it up chalk it up to bad debt you need to make sure you get approval for that write that sucker off and keep track of it because you need to make sure you know how much you're losing because of those types of um of issues because that is evidence since when you have timely filing denials evidence that something is broken goes back to step one it's broken in your revenue cycle something is not happening correctly if you have timely filing denials you have a broken revenue cycle something is not working okay and I know this from personal experience things happen and it's just it's very clear evidence that I and I can chase it back I can say oh something's not happening right maybe somewhere someone didn't correct something in a Clearing House it sat there for too long maybe somewhere the software was glitchy something didn't quite happen with the software okay this is where you can take the Deep knowledge deep understanding of the revenue cycle and piece it together all right I had this conversation with someone earlier today um or yesterday we were talking about um you know the process and like how can we just like write down all these things why don't we just write down exactly the scenario for a solution for X Y or Z bottom line is that at some point you have to just have a deep knowledge and understanding in these concepts of the revenue cycle so that you can know when there is a problem you have to you have to be able to discern right you have to you can't give someone a recipe for everything sometimes it actually takes a little bit of logic and a little under a deeper understanding little logic and a sense of what do I see what do I think is the problem digging a little deeper finding some evidence okay so those are five tips so they'll go over them quickly again just in case you miss them start by preventing so optimizing step one will stop by preventing optimizing your revenue cycle step two was find the right report do whatever you need to find that right report step three that is three step three is um create a strategy for working on your report step four is make sure that you're monitoring your aging buckets very closely and adjusting where you need to adjust and four is when it's done it's done just call it write it off stop wasting time and confusing yourself with a must a mess and a muck in your report so um so yeah so friends that are here what do you guys have to add to the conversation tell me what what's on your mind what questions do you have what things are coming up for you if you're listening to this live on the live stream or listening to it in the recording I want to know I want to hear so I love Larissa is sharing I'm gonna pop this on the screen okay my AR is a little out of control 120 days when I started turning bad with the company that I worked for yeah would love to get my AR tight and have it have everything on the AR before 120 days yes girl 120 days it's so funny when we think about like like I talk to people like it's a long time when you see something that far down on your on your Asian buckets it um it can be a little bit like and cause a little anxiety um because especially if you start to see it's way higher than your current which is zero to Thirty um from the current business that are being occurred that means that you know the practice is probably not um growing as fast as the mess that is there so um so it you need to you need to tackle it very very quickly and sometimes Larissa what I said the very last Point sometimes it's being super duper honest about things that are just too old just too old so you need to decide or have your pra your practice administrator if you're not if that's not your role you need to decide is it time is it time for me just to call it and write off anything that's older than a year or whatever the average I typically recommend that you're looking very closely at things that are the average timely filing limitation for the insurance carriers that you are used to working with so what what carriers are that that's um like an example just though United Healthcare if you work with a bunch of carriers like United Healthcare and everything over 90 um is is uh considered Beyond timely filing or past timely filing if you're working with a lot of insurance carriers like that then you are going to be very cognizant of the fact that anything that's older than six months is probably something that needs to just be considered potentially considered for write-off now and I'm not saying just give it up and just like write it all off in one float one stroke no I mean like instead you're going to take that subset of anything older than six months and you'll have someone scrutinizing it and review reviewing it if a claim you know you don't have proof you know the claim went out too late for a host of reasons provider forgot to close out documentation nobody found it whatever if that takes place you're going to need to make the call and say I can't we just can't excuse me we just can't waste our time and and waste our energy having that sitting on our report you have to just make the call and write that sucker off okay um so yeah let's keep I love you so yeah Maya reports are um our aging on Excel spreadsheet so I actually I don't have a problem with that as long as it's organized on the spreadsheet Larissa because um sometimes I see Excel spreadsheets that you can't um there's a lot of like characters or text in there that is not um resortable um like special characters that don't allow you to Resort by um amounts right by uh the dates of services by the age or the date so I don't love it when they when they don't have useful information that is resortable and we can talk more about that when I can pull an example up but um but other than that I I'm all for like I'm all for something that is able to be sorted so it couldn't have to be an Excel spreadsheet but if it functions like one that allows you to sort um the criteria search for criteria eliminate exclude whatever so good so good hi there I see Facebook user hi um okay Pocky what is the protocol for handling patient inquiries and disputes related to their accounts sorry um receivables and how can we ensure that those are resolved in a timely and satisfactory manner that's a good question that is probably one that we should have a separate like full discussion around because I think that there's a lot of I could have a lot of suggestions around the ways to handle the patient calls um the protocols for handling patients inquiries I'm going to say talk about that first so first of all patients have the right to ask questions about what's happening with their claims because when they get denial if you're on the patient side you get a denied EOB you see typically we'll see zeros across the whole thing and then maybe a big fat value that is assigned to your name the patient right and that's not a good feeling when you get something in the mail and you're like oh my gosh my doctor didn't get paid you kind of know that there's a chance you're going to get that bill or something is going to happen so I think it's helpful for us to leave the door wide open for our patients to ask questions all right um what's the the right way to to have them ask the questions it really is going to depend upon the features that are available to the software I love when the patients can communicate by sending in a request I don't love when the patients get someone on the phone right away and I'll tell you why when I speak to this I know that people don't like having to leave messages and things like that but the bottom line is that it just wastes so much time when a patient has to call a provider's office and and then sit and wait while someone is trying to get answers to those questions it's it's annoying for both parties the patient having to wait it's annoying but then also the uh rep the accounts receivable or the AR rep or the the uh biller the medical biller that is picking up the call is probably a little bit more flustered trying to scramble answers that they might give the wrong answer they might give the wrong answer because they're just they're under the gun someone's on the phone oh my God oh my God and the patient's upset or whatever irate who knows right so it's just so much better when a patient can send a request in to say hey this is what I'm looking for feedback on or understand to need to understand X Y or Z information sometimes it's better for want to have someone taking the call take the call and have them let them know right up right away just say straight up I have billing expert team that's going to be better you know student to help research your issue I want to make sure you get the right answer so I'm going to take your information down and they'll get back to you but be very honest about the time frame that it takes for you to return the call if you cannot return that call within 24 hours don't say You're Gonna return the call in 24 hours don't say it it doesn't make any sense when people do that I'm like if you have control over your time frame make it a realistic time frame don't be telling people like unrealistic things okay um oh my gosh let's see okay I'm looking at other comments here this uh I just read yours Tyler that broke my heart we'll talk about that okay how can we ensure that I'm just re reading the second part uh disputes related to their account streamable how can you ensure that they're resolved in a timely and satisfactory manner so um when a patient has um a dispute around what the way the claim is processed or um whether or not they actually owe for a particular deductible or an amount or something like that um I love when a patient is able to be engaged in the process when it's something that is their their value the the commitment Financial commitment that they're responsible for when I say that I mean like have them send a request they typically have the ability to do this online Um send a request online for reprocessing or reviewing of that claim as well as sending a request from your side the biller because it's just that much more possible that we're going to get a real and truthful resolution to the problem so don't um don't just take on responsibility for that without engaging the patient because the patients they are the consumers and the insurance carriers want to keep them happy because they still want their money quickly so so they care they don't they don't care about keeping the providers as happy because they're paying us money okay so they care more about keeping the patients happy because that satisfaction rating is what keeps the the um groups if it's a group health plan that keeps the groups coming back it keeps the patients paying their premiums okay so the patient has a lot of weight if it is something that's patient responsibility related just very graciously a script around asking the patient to please be a part of the process and if you want to give them an actual um phrase to State you know like if you're communicating with this patient on a on a portal you might even give them like almost a template of language to ask their insurance company to review or reprocess their um responsibility or deductible or whatever that you know Financial commitment is that you're that they're disputing okay that's probably the most common dispute that I see a patient calling on um Pocky but if there's other ones that you're thinking about let me know let me see all right I love it celebrating Marissa Larissa Marissa I just I just I just shipped your names together celebrating um laurissa there Marcy Marcy loves it so Tyra I saw your your message and this just like made me want to cry a little bit so you're working accounts for 2021. is that all that you're allowed to work nice sorry so the thing is this is like there are some Specialties where um you know you're you're battling clean processing underpayment overpayments things like that um so it it might be okay realistic what have you to to be doing um working on those older accounts you know it's just like insurance carriers those of you who don't know they hire companies outside agencies to um audit and review their claims processing from years past that's why sometimes we get these random letters from outside companies that have performed audits um and now they're asking for recruitments that's because it's a separate company that comes in and does the Audits and so that might be something that you're kind of doing is like oh going back and saying underpayment overpaying you could do that for old claims for sure now the likelihood of an insurance company these days like saying like oh we're so sorry and let me fix that for you when it's from 2021 is few and far in between but it's still possible it's just not as possible as other as other as other claims so like this so the mindset about yeah uh on a numbers worksheet I think it's called so difficult oh man I'm sorry I'm sorry Marcy so it's not a pretty sheet yeah that's the problem is sometimes you know people put things even in Excel or like Google Sheets and it's data that just can't be modified you can't do you can't do any sorting or reorganizing to create structure so I like it yeah yeah yeah Larissa's agreeing I love and do yes hey I want to be natural hello great to see you great to see you yeah I love this Muhammad's great got a great tip here so tell them about discover report to avoid age and claims great tip yes okay scrubbing reports so scrub there's there's a couple of different types of scrubbing reports depending on your software I should say Let me let me preface with that so we can create our own scrubbing report by having a report that comes from your software that gives you the opportunity to review all of the claims Data before it goes to the insurance if you don't have a formal scrubbing report now what is a formal scrubbing report from a software it is a report that the software does its own scrubbing for you and it just gives you the things that are not correct which is very nice um there are software out there that do actually look for correct information it's looking for dates of dates date of birth being accurate or at least making sense it's looking sometimes for like sex matching So like um someone doing a procedure that's typically done on a female when there is a male as the gender in the um the demographic information like those are things that software's intelligent software can scrub for it can look for okay but modifier is being used and it's not appropriate for a particular insurance or a procedure code being used that is possible scrubbing from a software in some cases I will say in many many cases it's not it does not happen so if that's your situation you're in the software that doesn't have all the bells and whistles you can do a manual scrubbing by reviewing the data that goes on the claims before you send it to the Clearinghouse so that is one method of scrubbling the scrubbing the other side of it is the actual software excuse me Clearinghouse itself the clearinghouses typically have their own scrubber as well built in if it's a good good Clearing House when I say good like y'all the free Clearing Houses are not good Clearing Houses I'm sorry you got to pay for it if you want something done well for you you have to spend a little bit of money and it's not a ton it's there's so much value when you actually invest in tools that serve you okay you have to be willing to invest and I'm not gonna I'm Not Gonna Knock all the the I know there's a lot of you out here using some of those free Clearing Houses just know that you are missing opportunities to improve your revenue cycle massive opportunities to improve your revenue cycle massive okay all right I hope thank you Muhammad for that thank you for that reminder yeah so those are really the two at the the scrubbing reports are going to why is that important it literally does edit it air cleans the entire claim before it goes to the insurance company and then they adjudicate your claim and find or don't even accept it for adjudication reject your claim because it's missing information okay or they adjudicate it and find that you know you you put gender Incorrect and it doesn't make any sense for the service or what have you like things that just shouldn't happen Okay so oh Tyra I'm sorry I'm sorry yo you do the current as well okay all right all right good so what are we doing with those old ones does it need to go where does it need to go let's see okay I am processing claims on productivity very stressful and processing claims on productivity so I want to be higher paying job yeah not productivity Okay so processing claims on productivity man okay so let me let me try to think of a way to explain I know what you're saying I'm just trying to think of a way to explain that to folks who don't necessarily know what that means um basically what wannabe natural is saying that um when you process claims on productivity it means that you're like you're getting the claim information to be able to maybe manually key or enter the claim to create that claim to send it to the insurance company and you're getting basically scored on how many you're able to get through how quickly you're able to get through those claims is kind of equal the the marker for whether you're doing a good job and how that is very can be stressful is that you gotta fly through information and sometimes you miss stuff and sometimes sometimes it's like you're racing up against the clock basically um and depending on I'm sure like the specialty and the size of the claims that can it can it can be quite um time consuming with certain claims so then you're you know really feeling that like angst so I hear you I feel you um the reality is this is like typically and I'm going to play Devil's Advocate a little bit typically organizations determine productivity on the um claims processing based on historical information so they are looking at what is like an average production done by a team member that's trained that you know experience what have you and that's typically and I say typically because not everybody makes like targets off of real information but if they're doing things correctly they have set their targets up based on historical data and I would say you know talk to maybe other folks that are on your team and try to um get a feel for whether it's realistic because you guys could potentially collectively challenge the target you could um I I would just be mindful of the fact that you you need to understand first the basis of where that Target came from because if it is because they've been able to achieve that you know 98 of the time then your next question want to be natural is what is everyone else doing that I'm not doing like what can I learn from my counterpart about you know how to improve so um I like it do well and move up yeah yeah so summer I love it yes do well move up continue to improve that you know that's all that's all we can ever do in anything that we do in this life and especially in healthcare is like that commitment to constant Improvement because it's the next opportunity for us to to be more fulfilled like you might not necessarily want that next level role with all the extra responsibilities and things like that but you might want to just be more satisfied more fulfilled on the job and that in itself that can be so much more valuable than than monetary benefit is feeling like you have kids sleep at night and you're not feeling stressed and all of that so let's see oh yeah okay uh processing so many an hour yes Gordon quality and quantity okay so quality and quantity is the score that's a fun coming uh mixture right isn't it fun to have both of them together um and it's like we want you to go really fast but you have to be really really so I I believe in it I'm all for it as long as you know they're giving you the right training to help you understand how to achieve those targets right how do we achieve those targets so really great comments my friends what else you guys got for me today what else what other questions are you guys have for me this evening I could talk about AR for a very long time today we stayed fairly high level we'll say with regards to the discussion around accounts receivables those of you who are interested in going deeper into this discussion of accounts receivables I want to know from you where are you struggling tell me what you need to know more about what are the gaps where are you feeling you need to have us cover first we have already the next few weeks of content lined up most of it is related to account receivables but I have the ability to kind of resource reorganize augment what have you the content so that I can make sure it's relevant so we can talk about things that actually matter to you everything that matters to you so oh I like okay here we go I just hit my eye I think I just hit my eye on the mic that's funny okay or my eyeglass eyeglass um so when I get anything you can provide for my impersonate Sports coverage but yes coverage positions okay uh yes tell me tell me more about the coverage positions is that locum's tenants tell me what you mean by the last part there um Osama so I Like It where can you take online courses on AR we have that on our plans that's actually on our plans um but right now we'll we'll build the course together here on the live streams I think uh want to be natural there is not there does not exist at the moment in my research a very beautifully comprehensive training on account receivables um at the moment and there's there are some programs that added into their um their schooling um I don't know that I've hadn't heard any great feedback or anything about any particular one but I will say it like let's let's develop your knowledge here while we are continuing to develop that accountable program or ar program because it is it needs its own training right especially if you don't have a great um training team or the training information that is there in-house is not um as valuable so do you have any existing YouTube videos about accounts reviewables so hi Kelly um any existing videos about responsibils it Dives a little deeper hmm I have I think not not they need not any deeper than we talked about today at the moment maybe just a count age receivables aging buckets I think aging buckets metrics based mostly I think is what what we have what I'll do Kelly is um I'll look on the channel and um put links into the description box of anything that we have related to it and um I want to know tell me tell me exactly what you're looking for and what we can do is start to craft that in our plans we have a whole our our content engine is up and running and have lots and lots of stuff in store for you guys if you haven't seen that we started doing shorts um that's fun um and then we also have videos that are going up like actual recorded videos that are are going up on a regular basis now too so we are adding a lot of regular content I have made more time so um and I'm looking at others so but Kelly let me know what you're interested in so I can make sure we have that in the plans I really want to know for sure let me see evidently say where can I get where where I'm sorry where can I get the clients to work do you have any network that can help nine years of experience um so you want to find clients to work for right um I could I I don't have a good answer for that right now Avinash um I'm sorry um I would say just keep sticking around the circles that you're in and um continuing Network let me think about that a little bit we have we have some videos that talk about job searching and stuff um but I hope that's helpful so yeah Tyrus Tyra's um commenting I think I want to be natural the productivity expectations yes I know they can be stressful but listen you guys know that I I run the company so for me it's so important to have targets and clear paths to like what the expectations are because even though you might be a really fantastic worker want to be natural in Tyrone you guys are hanging out with me on a Thursday night I'm a guarantee that you probably care about what you're doing there are a lot of people that don't so most people need targets to March towards so that they can know that they're doing a great job so I like that so Bella hello let's see I recently promoted to a supervisor IB feeling company and now I manage both billing and AR yay okay okay so strong and billing not so much in AR currently struggling with denial recent code standing Insight yeah we're going to talk about denial codes actually um so and you're in the Facebook group so if you are not in the Facebook group my friends who are watching on any other platform LinkedIn and where am I LinkedIn and YouTube um basically we are trying to do a medical billers Network Live Meetup once a month we are organizing a medical Village Network Live Meetup once a month in which we will have breakout rooms to discuss things like denial reason codes and there is a poll going out sometime soon Nicole and I we actually had a meeting earlier today to go over the the um breakout session breakout rooms that we are going to um to have basically where you guys will be able to get into those rooms and talk about things like you know what are we going what are we experiencing like with a particular code what are your recommendations on how to like fix it and it'll be an opportunity for us to dialogue um about your challenges and then really kind of Workshop like what the possible solutions are so I'm super excited about it it's like something coming to life that I've really wanted to um to create for for y'all for a very long time so um so I hope that I hope that that is something Bella that helps you um as far as developing an AR it's going to just take a lot of understanding of what you did in Billing and how that impacts what actually takes place in AR because a lot of us have a way of like segmenting or separating the two thinking that billing is its own world and AR is its own world now filling is where and you guys those of you who don't know what I'm referring to when we say billing typically that is where claim is created to go out the door goes out the door maybe even wear a rejection from the Clearinghouse monitoring might happen as well sometimes where a charge entry might happen or a coding will happen in that area of billing okay when people say billing AR is often a separate team separate department and really billing informs the accounts receivables so just like my first tip today where I talked about prevention so important that we understand that it has to be you have to focus on optimizing what's happening in the billing so you can use what you did in Billing to inform the possible issues that you are seeing on the AR report so you can potentially resolve those denials that you're seeing faster because you kind of already knew a lot more about the data itself that was going into the claim now here's the problem with sometimes with billing department billing department doesn't always get informed about the results of their errors so billing department sometimes Powers through on productivity like we were just talking about not all billing departments have really great measures for errors and um and error rates things that are caused by indivi