As Zero-Balance Review specialists who work with many healthcare providers across the country, we can confirm that Zero-Balance Reviews are growing in popularity each year.
While the results achieved clearly support implementing a Zero-Balance Review in most situations, revenue cycle leaders still have many questions.
Are Zero-Balance Reviews effective? Will my team be replaced? What’s needed to start a Zero-Balance Review? Who owns the recovery process?
We know because we hear these questions every day.
To help you decide if a Zero-Balance Review will work in your revenue cycle, we’ve answered the most frequently asked questions about ZBR.
Zero-Balance Review Questions & Answers
What is a Zero-Balance Review?
While the scope and quality of a Zero-Balance Review can vary, a Zero-Balance Review analyzes zero-balance insurance accounts to identify and recover previously unknown or unrecovered underpayments and denials across various payer types.
Which Healthcare Providers Can Benefit from a Zero-Balance Review?
Most providers can benefit, but it’s most effective if the following is true:
- You have over 1,000 annual discharges
- Less than 75% capitated patient volume
- Your EMR is capable of generating claims data
Are Zero-Balance Reviews Useful if We Have a Contract Management Tool?
While contract management tools are effective for routine claims, Zero-Balance Reviews can catch the more complex underpayments that may bypass or be incorrectly processed by these tools.
How Often Should a Zero-Balance Review Be Completed?
Initially, a 12-24 month retrospective review is a good starting point. From there, monthly or quarterly reviews are common, depending on provider’s size, resources, and payer agreements.
Can We Do a Zero-Balance Review Internally?
Yes, if you have the necessary technology resources, analytical resources, and dedicated skilled staff then you may be able to perform a Zero-Balance Review internally.
What’s Required to Start a Zero-Balance Review?
You’ll need to provide a data extract, payer agreements, and EMR/EHR access.
Who Manages the Appeals and Follow-up Process?
This can be handled by your team internally or by your Zero-Balance Review partner serving as an extension of your team.
Why Do a Zero-Balance Review?
By prioritizing these no-value claims and thoroughly analyzing them, benefits can include:
- Increase Net Revenue
- Improve Payer Compliance
- Improve Revenue Cycle Processes
- Prevent Underpayments
- Improve Margins
Can I Limit the Scope of a Zero-Balance Review?
While it is not recommended, it’s possible to exclude a specific payer, payer classes, or claim types if necessary.
When to Skip a Zero-Balance Review?
Consider skipping if you are highly concerned with:
- Severe resource constraints
- Negative staff perception
- Sensitive payer relationships
- Competing higher-priorities
- Unpredictable revenue recovery potential
Could a Zero-Balance Review benefit your organization and revenue cycle operations?
What if your zero-balance accounts were prioritized?
At Boost Healthcare, we specialize in comprehensive Zero-Balance Reviews. Speak with our dedicated zero-balance review specialists that prioritize zero-balance accounts daily.
%20a%20Good%20Fit%20for%20Zero%20Balance%20Review.jpg)
