Accounts receivable recovery in behavioral health requires a unique approach. Unlike other medical specialties, behavioral health claims often face additional scrutiny around medical necessity and prior authorization requirements.
Here are five proven practices that can improve your A/R recovery rates significantly.
1 Segment Your A/R by Age Bucket
Not all aged claims require the same approach. Organize your A/R into buckets:
- 0-30 days: Normal follow-up cycle
- 31-60 days: Increased attention, first escalation
- 61-90 days: Intensive review, identify patterns
- 90-180+ days: Specialized recovery tactics
Each bucket requires different resources and strategies.
2 Know Your Payer Timely Filing Limits
Every day counts. Illinois payers have varying timely filing requirements:
- Medicare: 12 months from date of service
- BCBS IL: 365 days (commercial), varies by plan
- UnitedHealthcare: 90-180 days depending on contract
- Aetna: Usually 90 days from initial claim
Track these limits and prioritize claims approaching deadlines.
3 Document Every Payer Interaction
Maintain detailed records of every call, including:
- Date, time, and representative name
- Reference/confirmation numbers
- Specific information provided or requested
- Promised timelines and next steps
This documentation is essential for escalations and appeals.
4 Identify and Address Root Causes
Look for patterns in your denials:
- Are specific providers seeing higher denial rates?
- Which CPT codes are most frequently denied?
- Is one payer causing disproportionate issues?
Fixing upstream problems prevents future A/R buildup.
5 Know When to Bring in Specialists
Your internal team may not have bandwidth for 60+ day claims. Signs you need help:
- A/R over 90 days exceeds 15% of total receivables
- Staff is focused on new claims, ignoring aged ones
- You're writing off claims that could be recovered
Specialized A/R recovery teams can focus exclusively on these challenging claims.
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Effective A/R recovery requires systematic processes, detailed documentation, and knowing when to escalate. By implementing these practices, you can recover more of what's owed to your practice while maintaining positive payer relationships.