Problem Statement

Accounts that won't be collected in full have to be adjusted or written off so accounts receivable reflects what's truly collectible, and much of this follows clear, rule-based criteria - expected-reimbursement variances met, generic low balances, timely filing, Medicaid secondary, bundling denials, modifier and split-claim write-offs. Because the rules are well-defined but the volume is high, manually adjusting each qualifying Hospital Billing and Professional Billing account is repetitive work that backlogs easily and leaves non-collectible balances sitting in AR.

Automation Solution

This automation adjusts Hospital Billing (HB) and Professional Billing (PB) accounts that meet expected-reimbursement, low-balance, timely-filing, or similar write-off rules to clear non-collectible accounts receivable.