[Insights] 4 Signals Your Biller Is Struggling with AR

And strategies to optimize your eyecare practice's billing process. 

By Melissa Jacobson

Are you worried about the financial health of your eyecare practice? Do you wonder if your billing team is keeping up with their responsibilities? Is there money owed to you that's going unclaimed? These are pivotal questions that every eyecare practice owner should be asking themselves.

Effective billing management is crucial for the financial well-being of your practice, but it's easy to miss subtle signs of trouble. Drawing from my billing experience, which includes serving as the COO of a ten-location optometry practice, I’ll share my top 4 tips for identifying whether your biller may be falling behind—and proactive strategies for you to optimize your eyecare practice’s billing process.

1. Escalating Accounts Receivable (AR) Balances

Sign: One of the most significant warning signs of a billing issue is a consistently rising balance in your accounts receivable (AR). If you've noticed this trend, it's time to take action.

Strategy: As a practice owner, it's essential to regularly review your practice's AR reports. Pay close attention to the aging of unpaid claims, especially those older than 90 days. If you identify substantial amounts in this category, it's time to act. Collaborate with your biller to understand the reasons behind the growing AR balance and work together on an effective plan to optimize your eyecare practice's billing process.

2. Lingering Claims Older Than a Year

Sign: Claims that have been outstanding for over a year should set off alarms. Such aged claims may suggest that your biller isn't effectively following up or resolving issues with insurance providers.

Strategy: Initiate a discussion with your biller regarding these long-standing claims. While there may be valid reasons for the delays, your biller should be able to provide explanations for each case. For example, they may have appealed a denial and are awaiting feedback. The key is to be aware of timely filing deadlines for various insurance providers, as claims typically require resolution within a year. Investigate and address any unresolved claims promptly.

3. Neglecting Explanation of Benefits (EOBs) Posting

Sign: Occasionally, billing departments may overlook critical tasks such as posting Explanation of Benefits (EOBs) or fail to reconcile bank deposits with your practice management software. Billers might skip EOB postings or reconciliation due to the complexities of handling numerous EOBs, heavy workloads, or occasional oversights.

Strategy: Ensure that your biller consistently posts EOBs and reconciles bank deposits with the corresponding payments in your practice management system. This proactive approach helps identify discrepancies and ensures that all payments are accurately recorded.

4. Missing Claims

Sign: In some instances, claims may not even be generated or submitted, resulting in lost revenue.

Strategy: Implement safety net reports offered by your practice management software to verify that all services provided during examinations result in the creation of corresponding claims. Regularly review these reports to ensure no claims are overlooked or omitted. Establish processes to ensure that claims are promptly generated.

Despite your best efforts, internal billing challenges may persist. These challenges could include a continuously growing backlog of unresolved claims, recurring billing errors, or inadequate resources to manage billing efficiently. 

It’s important to remember that managing even the smallest details of insurance billing is important in building a thriving practice. By recognizing these signs and implementing proactive strategies, you can optimize your eyecare practice's billing process, safeguarding your practice's financial health.