Have you ever wondered how a human-centric ambulance billing process works? Let’s find out! In this blog series, EMERGICON will walk you through the daily personalized service offered by our 100% Texan team members and show how our Texan Touch® approach is unique. This week let’s learn about the Accounts Receivable team.
The Accounts Receivable (AR) Department is responsible for following up on the payment process of claims (or tickets) that are pending or denied. We spoke to AR Manager Kellie Wheelock, AR Lead Diane Mansfield, and AR Specialist Briana Stratton to better understand the department’s responsibilities.
According to the AR Manager, in a perfect scenario, once the Billing team finishes the ticket process, the patient’s insurance provider or other healthcare coverage pays for the bill, and the claim cycle continues in the Cash Applications Department. However, not every case is like that. “We work on those tickets that are sitting for longer than 30 days. It is our job to find out why it is still open and how to solve that,” describes Wheelock.
Many reasons could explain a pending or rejected claim. “Every day, we pull reports and review all the documents attached to the tickets to see if there’s any explanation for why the coverage provider has not paid the bill yet. It can be a simple demographic error, information that is not updated, or a failure to meet certain documentation requirements, etc. So, our job is to investigate and find out what is happening with each ticket,” says Mansfield. “If I can’t find anything from the reports, I call the insurance to verify what’s going on with the claim. Is it in the process of paying, or is it denied? Then, if there is a denial, it’s time to work on an appeal,” explains Stratton.
The AR Manager, Kellie Wheelock, defines the job as a puzzle game. “Every healthcare coverage (Medicare, Medicaid, Commercial Insurance) has their timeline for payments, revisions, and appeals. We must be familiar with the hundreds of insurances out there, their ins and outs, guidelines, and billing processes because they are so different. It’s a library’s worth of information. It’s like a big puzzle you need to put together,” added Wheelock.
The Texan Touch®
The Accounts Receivable team embodies the personalized approach that distinguishes EMERGICON as a true partner for EMS agencies by displaying the efforts to go above and beyond for clients. That’s what we call the team’s Texan Touch®. “We always pay attention to patterns. We investigate reoccurring issues and pitch possible solutions. Our goal is to simplify the process and avoid running into the same issue again,” states the AR Specialist, Briana Stratton.
“It is crucial for me to put myself in the client’s and patient’s shoes. Also, to always be available to assist, help and answer the team’s or client’s questions. Making it an enjoyable experience for all parties involved is essential,” AR Lead Diane Mansfield explains. “Ensure that the processes are streamlined; assure that the team is trained for the various possibilities; and develop a connection with clients, so they feel comfortable to reach out when they need,” lists Wheelock.
Sense of Purpose
When asked why they love their jobs, the Accounts Receivable team members listed different reasons. “I love the challenges. Working with AR it’s not repetitive, and it’s not dull. You’re always learning, growing, and improving. It makes me feel accomplished,” declared Mansfield. “The opportunities. There’s no holding back. Your efforts are recognized and rewarded. They don’t go unnoticed,” expressed Wheelock.
“I went to college for Coding and Billing. This is the career I envisioned for my life. I’m lucky I landed at EMERGICON because this team feels like a team. Everyone is so warm, available, and united,” said Stratton.
If you are interested in this career path, we have great news! EMERGICON is always accepting job applications. Check the current positions available on our Careers page or send your resume to firstname.lastname@example.org.