Using Technology to Enhance Payor Follow-Up

Many payors allow representatives to follow-up on more than one account in a single phone call. Prioritizing accounts by payor, balance, age and plan code (virtually unlimited selection criteria), enable account representatives to “look ahead” and get the most from each call. Patient accounting representatives can efficiently follow-up on multiple claims, minimizing the amount of time spent on hold.

Prioritizing business office staff efforts allows managers to expend resources where the return is the greatest. Managers can place accounts in account representative work queues using any appropriate criteria.

Action codes and result codes are management-defined activities presented to account representatives when working payor receivables. When selected, the system should apply automated processes that direct the next appropriate step. These management-definable action codes and result codes allow business office rules to be automated and enforced. This automated workflow approach improves account representatives' efficiency and accuracy by placing management's rules and experience at their fingertips, controlling follow-up actions.

A system that can capture, trend and respond to payor denials ensures prompt response and quick problem resolution. As rejections are captured, a system should trigger workflow to automate the management-defined response and log appropriate payor statistics for trending reports.

“Overall fiscal year cash performance for July-November has increased more than $7.9 million after our first full year of operation. The results have been nothing short of phenomenal. We're improving the financial results, but we're also seeing a side benefit of improving our customer service and the way we are interacting with patients. The technology has helped us really become a much better organization.”

Matt Castellano
Director PFS Systems Support &: Training, UNC Hospitals

Incorporating supporting departments such as medical records into your account flow ensures timely response by critical departments. Tracking departments' responsiveness ensures they are contributing to successful claim follow-up.

Empower your follow-up representatives to check claim status or verify benefits by using Web-based online services. The Web-based resource is presented to account representatives within one convenient application, eliminating Internet searches for the target site.

Payor Follow-Up
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