AR Inventory Analysis, Identifying Trends, Upload the Inventory to get the Analysis Report

AR Inventory Analysis is the most important part that will help to make the strategy on how can you start working on the inventory? and how many resources are required to complete the inventory in a specific time period?

It helps to complete a higher amount of work within a minimum amount of time.

It is a difficult task when you are trying for the first time and requires AR knowledge as well to identify trends.

But once it is prepared then based on the strength of your team members, you can allocate the claims and complete them within the given time frame.

Below are the pointers that will help you to prepare an inventory analysis summary and identify trends,

1. Identifying Workables/Non-Workables:

• It is necessary to first bifurcate workable and non-workable claims. Non-workable claims include claims that are not allowed to work. Non-workable claims could include,

• Any specific payer (As instructed by the client)
• Specific Aging bucket (As instructed by client)
• Claims that are already in the patient bucket.
• Claims with zero balance amount or negative balance amount.

2. Identifying Callable and Non-Callable Inventory:

• Identifying calling and non-calling claims is the most important since we get a limited time in a day to get status on call. This bifurcation will help you while allocating claims.

• This will help to utilize the entire shift hours.

• You can also create a separate team to work on callable and non-callable claims.

• Non-callable claims can be worked on a higher percentage that will balance the entire day's work.

• Non-callable claims can be identified based on the workflow given to work on any denials or payers. For example, Eligibility related denials such as 31 - Patient not identified, 26 - Coverage Terminated, 22 - Other payer primary, and many more. These denials can be worked directly through the website if website access is available.

• Non-callable claims can also include claims where website access is available and you can utilize the website to get claim status.

• These are some examples but based on the workflow, you can identify which claims will require calling or not. 

3. Defining Aging Bucket:

• Aging Bucket will help you to target the claims timely before it crosses the TFL/AFL.

• It is good to target the 90+ days bucket first on no-response claims.

• Aging days between 30-90 are too early to work on no-response claims.

• When working on denials, an aging bucket of 30-90 can be worked initially since these claims have already been denied.

4. Denial trends based on payers:

• You can create a pivot of denials versus payers that will help you to identify specific payers with a high volume denial.

• This is very helpful while identifying Credentialing denials.

• Resolution to these credentialing issues will resolve the higher number of claims.

• You will also get other denial trends when you will create this pivot. Credentialing denial is just an example with a higher possibility.

5. TFL/AFL Crossed Claims:

• If you have a year old claims in your inventory then this will be very helpful to eliminate claims where TFL/AFL crossed and those claims can be adjusted off.

• Based on the TFL and AFL of a particular payer, you can identify claims that cannot be reimbursed since the TFL and AFL of that particular claim are exhausted. You can get the approval to adjust all such claims.

• For Example, Medicare claims cannot be reimbursed if the Date of service crosses 1 year. Taking any action on that particular claim after 1 year will not work and that claim needs to be adjusted.

6. Not an Insurance Claims:

• You can identify payers that are not insurance from your inventory list.

• To identify such payers, you will need to check the insurance name. Sometimes, by reading the name you can identify that this is not insurance.

• The volume of such claims will not be much higher but it will definitely help to remove this small volume quickly.

• These claims can be released to the patient or billed to another active insurance.

Above are a few factors that will be helpful in Inventory analysis and identifying trends. But, this could include many other factors based on the actual inventory. If you want, we can help you in creating an Inventory analysis report by identifying trends. Just fill out the below details and upload your inventory or email us your inventory to contact@arlearningonline.com

Upload the Inventory for Inventory Analysis Report:

Please remove PHI information from the Inventory.

Note: Once inventory is uploaded, we will send the confirmation email to your email ID within 24 hours. Please provide the confirmation then we will start preparing the analysis report.

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