Accounts Receivables Process

At Greenshine Healthcare Solutions, our Accounts Receivables (AR) process focuses on identifying and resolving claim issues to ensure faster reimbursements and improved cash flow for healthcare providers. Our AR team carefully reviews unpaid or delayed claims and takes the necessary actions to resolve them efficiently.

Key areas handled in our AR process include:

• Authorization Issues – Managing claim delays or denials caused by missing or incomplete pre-authorizations for procedures or treatments.
• Referral Issues – Resolving problems related to missing or incorrect referrals required for specialist consultations or services.
• Medical Necessity & Medical Records Requests – Providing additional documentation or medical records requested by insurance companies for claim approval.
• Non-Participation with Insurance Network – Handling claims where providers are out-of-network with certain insurance plans.
• Terminated Insurance – Identifying inactive or terminated insurance coverage and coordinating alternative payment solutions.
• Coordination of Benefits (COB) – Determining primary and secondary insurance coverage to ensure accurate claim submission and payment.
• Wrong Diagnosis – Correcting diagnosis or coding errors that may cause claim denials or reimbursement delays.

Our AR specialists actively follow up with insurance companies, resolve claim issues, and work to maximize reimbursements while reducing outstanding balances.