Where’s the pot of gold that should be dwelling in your accounts receivable? The most common complaint I hear is that accounts receivable is growing, and providers can’t get paid. The year 2018 is all about the numbers influencing EMS. Today we talk about the magic number “90” and how using its magic can be the most productive route to the cash you need…or in honor of St. Patrick’s Day, the path to your pot of gold.


Every number has unique properties and cultural meanings. Ninety is the number of degrees in a right angle. If you were using a compass, 90 degrees corresponds to east. In our world, 90 days is the point in time where money is most likely to get stuck. If payment has not been received in 90 days, there’s a reason. I want to help you get to where 90 is pointing to the east for you – because that’s where the sun rises – and I’d like to see the sun shining on your cash flow. But you need the right approach to get there.


Here’s what is happens to many providers and sometimes billing companies as well – the focus is on getting claims out the door and dealing with daily correspondence. There is little time for follow-up. That’s because billing is complicated. There are regulatory issues, payer challenges and the work involved in creating and submitting a claim. Once the claim is made, providers await payment or denial. Many billing departments mark an account for follow-up and put it in a work queue. The second method we often see is that providers run a report of open accounts and work through that list.


I suggest you start working the power of 90.  Run an accounts receivable aging report by payer class. Calculate the total amount uncollected in the 90 days and over category. Take that number and divide it by the total amount outstanding. The percentage you get will show you what portion of your accounts are over 90 days old in each payer category. Remember, most claims should have been resolved before they reached 90 days old. If the percentage of unpaid accounts older than 90 days is significant (over 30%), there is a problem.


When looking at the commercial pay category, the percentage may be very high. If that’s the case, run a report that shows the individual insurance companies. Do the calculation outlined above again. The percentage should now pinpoint what commercial payers are not paying. The next step is to be targeted in your effort to investigate and resolve the problem.


For example, if Cigna claims have a rate of 50% unpaid, there may be an internal processing problem. Internal insurance pre-verification may be a problem. Possibly the hiccup is with the electronic claim submission process to this payer. There could be a problem with your clearinghouse (where claims get out your door, but they are not getting in the door at Cigna).


The point is, with information about the 90-day problem accounts, follow-up activities can be more focused and effective. However, staff needs to be assigned and dedicated to these tasks. That’s the real challenge of follow-up on unpaid accounts receivable – there needs to be bodies available to do the work. It’s a crucial part of the billing process.


Look at staffing configurations and adjust if possible so people can exercise the power of 90 and get the sunshine from your cash flow shining on your organization!


Since the numbers of EMS are motivators of what we do, this year I will continue to address the numbers driving the topics of concern to every provider and billing agency. We will bring you practical advice or action steps you can take to better cope with the “numbers” and get to the pot of gold.


Happy St. Patrick’s Day!


About the author:  Maggie Adams is the president of EMS Financial Services, with 25 years’ experience in the ambulance industry as a business owner and reimbursement and compliance consultant. Known for a practical approach and winning presentation style, Maggie has worked with medical transportation providers and billing companies of all kinds to support their billing, auditing, and documentation training efforts. “Like” EMS Financial on Facebook, follow us on LinkedIn or for more info, contact Maggie directly at maggie@ems-financial.com or visit www.ems-financial.com