Accounts Receivable Analysis Paper

Accounts receivable analysis requires many different points of data in order to be sufficient. Required data includes payor information, patient information, billing information, registration information, and date limitations. Analysis must be performed based on the financial class of each payor, where financial classes vary by organization. The financial class system categorizes payors into contract generalization terms. Financial class 1 or 2 is considered Medicare services, where financial class 3 or 6 is considered Medicaid services. Each financial class must be taken into consideration due to each having their own regulations. In addition to financial class information, patient accounts are also categorized by payor. Each payor will have an insurance plan number for each facility. The Nashville branch of Parallon services 5 clients, meaning there are multiple facilities within each client, and multiple insurance plans within each facility. Major payor group will need to be determined for higher-level generalizations and statistics. Major payor group can also be used …show more content…
Vendor identification must also be included to determine if the account has been placed with an early out vendor for collections. Admittance and discharge date must be included because payment methodology is driven by these dates. Payor, or insurance, 1 through 3 must be determined for correct categorization of data and payment information. The total payment amount, total allowance amount, and total adjustment amount must be found for each payor sequence. Information from patient payments, allowances, and adjustments must also be identified. Additional information from the insurance remittance advice must be identified to correctly balance patient accounting information. Message codes and status codes must be retrieved from the remittance advices to categorize denial information, if