A/R at Start-Up

October 1, 2007

I started a solo surgery practice three months ago, and my A/R is only 7 percent at this point. I asked my office manager to review the accounts to see how we are doing, but she told me it’s way too early to do anything. What can I do to assess whether we are on the right track at this point?

Question: I started a solo surgery practice three months ago, and my A/R is only 7 percent at this point. I asked my office manager to review the accounts to see how we are doing, but she told me it’s way too early to do anything. What can I do to assess whether we are on the right track at this point?

Answer: In general surgery practices, 53.61 percent of A/R is collected within 30 days, according to data from the Medical Group Management Association. So even though you are just starting out, I’d expect to see more than 7 percent in the door by now.

I think you need to sit with your office manager and find out where the money is. There may be a good reason for the delays, but why wait another three months to discover a problem?

Ask questions like these:

  • Are claims submitted daily?

  • Is anyone reviewing the submission report from the clearinghouse to make sure they all went through?

  • Are claims resubmitted after 30 days if you’ve not heard from the payer?

  • What percent of accounts are patient balances and what are you doing to collect these as soon as possible?

  • Are all copays being collected at time of service?

  • Are you credentialed and contracted with all payers you are working with?

Basically, you need to understand the full picture of what is happening. You may not need to make changes yet, but you do need to understand fully what is going on. Ask every question even if it seems stupid and insist on an answer. It sometimes helps to play dumb since the manager will feel proud to educate you, but if she can’t illuminate the picture for you, you should probably dig on your own.