Managing outstanding claims.
An age analysis is only useful if something happens because of it. A simple, repeatable follow-up rhythm.
Most practices produce an age analysis. Far fewer use it, because the report tells you that money is outstanding without telling you what to do next. The gap between the report and the action is where revenue is lost.
Work causes, not rows
Sorting the analysis by value and starting at the top feels productive but scatters effort across unrelated problems. Grouping by reason instead, so all claims rejected for the same cause are handled together, means one piece of understanding resolves many claims.
Give every query a record
- A reference from the scheme for the query itself
- The date it was raised, so its own ageing is visible
- Who was spoken to, and at which department
- What the scheme said, in writing wherever possible
- The date it will be chased again if nothing happens
Chase on a cadence
Follow-up that happens when somebody remembers is not follow-up. A fixed rhythm, even a modest one, moves more than sporadic bursts of effort, because schemes respond to persistence and a documented trail.
Know when to stop
Some claims cannot be moved. Establishing that early, and recording why, is a legitimate outcome. It protects the hours that would otherwise go into claims with nothing left in them.
This article is general information about healthcare administration in South Africa. It is not legal, clinical or financial advice, and it does not describe the rules of any particular medical scheme. Always check the position that applies to a specific claim.