April 19, 2024

Top 5 Benefits of Zero-Balance Review in Healthcare Revenue Cycle Management

Brandon Pittman
VP of Business Development
at Boost Healthcare
Zero Balance

Healthcare revenue cycle leaders are great at getting things done - even if it means rolling up their sleeves and doing it themselves.

For many of these get-it-done type leaders who pursue perfection, the thought of implementing a Zero-Balance Review that retrospectively reviews closed accounts may seem duplicative and unnecessary.

When performed by experts, a zero-balance review repeatedly proves there is value in not giving up on zero-balance accounts.  No additional reimbursement expected, no problem.

What Is a Zero-Balance Review?

Zero-Balance Review retrospectively scrutinizes accounts with an insurance balance of zero to confirm whether full and appropriate reimbursement was received from the payer for the care and services rendered.

As the safety-net to healthcare provider’s internal and outsourced revenue cycle processes, a zero-balance review identifies and recovers lost revenue from contracted and non-contracted Commercial and Government payers.

What a Zero-Balance Review Is Not

A zero-balance review is not:

  • A replacement for existing internal processes and staff.
  • A displacement of valuable revenue cycle vendor partners.
  • A data analysis that stops short of recovering your lost revenue.
  • A limited review that neglects lower-dollar recoveries or more difficult payers.
  • A cursory review done by generalists or those who specialize in other RCM functions.

What Are The Benefits of Zero-Balance Review?

With most healthcare revenue cycle leaders focused on ‘open’ or ‘active’ A/R along with a plethora of other initiatives, your zero-balance accounts are prioritized by an unbiased extension of your revenue cycle team.

When prioritized by experts, these no-value claims become quite valuable.

Increase Net Revenue

The initial benefit of a Zero-Balance Review is the recovery of unknowingly lost revenue to missed underpayments and unrecovered denials from Commercial and Government payers.

Improve Payer Compliance

With data-driven insights into payer behavior, your Zero-Balance Review will help you understand how you can hold your payers accountable while also supporting your team with future payer contract negotiations.

Improve Revenue Cycle Processes

At your discretion, leverage the findings from your Zero-Balance Review to educate your staff and implement upstream process improvement opportunities.

Prevent Underpayments

With detailed actionable reporting and root-causes, your Zero-Balance Review will help you eliminate preventable underpayments and denials.

Improve Margins

The culminating fifth benefit of a Zero-Balance Review is margin improvement.  Between recovering up to an additional 1% of net revenue that would otherwise go uncollected to staff education and implemented process improvements, your margin improvement is sustainable.

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