Revenue cycle management involves a complex interplay between services such as benefits analysis, billing codes, and efficient invoicing. In the past, hospitals and other companies were able to get 90% of their funding from insurance companies, and the patient component received much less attention because it was only a tiny portion of total revenues.
It’s not the case anymore and increasing numbers of Americans are getting insured through high-deductible plans. The patient’s liability could end at about 30 percent in medical expenses. The issue is that for every dollar of patient care that’s charged, hospitals have traditionally taken under 50 cents.
The traditional billing system was designed to collect smaller, more amounts from insurance companies, rather than a greater, lesser amount from individuals. A sound revenue cycle management healthcare demands that this mentality change.
Reasons Bills Go Unpaid
Prior to the Affordable Care Act being passed, high-deductible Healthcare solution provider & plans were becoming more popular and, with the shifts in reimbursement patterns, reimbursement patterns began shifting.
At one time, doctors and hospitals did not have to create interactions with patients regarding the cost of their bills since they got the bulk in their payments from insurance companies. They concentrated their efforts on insurance companies and didn’t have any efficient ways of communicating with patients to get them to pay off their bills.
The deductibles for plans that exceed $2,000 are not unusual these days and as the overwhelming majority of Americans with under $1,000 worth of savings, it is clear that this could be the possibility of an issue.
Make Sure Technology Is Up to Speed
One of the most important steps hospitals and independent healthcare providers should do is to ensure their technology is up-to-date with the mobile, tech-driven environment that patients are living in.
This includes offering mobile and online tools for booking, confirming, and canceling appointments, and online payment sites. Payment options online have been found to increase collections from self-pay as well as insured patients and drastically reduce the number of accounts that are entrusted by collection companies.
The ease of not having to utilize stamps, bills and postal services do more than just benefit your patients, but it will also cut down on your overhead costs. Statements cost more than paper. Think about the time and effort that goes into the process and also the envelope and stamp. When you combine these two factors, it usually results in patient statements costing approximately $5 per document, which can result in an annual cost of $27,000.
Let’s say that a business sends out 450 statements per month at $5 dollars per piece. The sum of 450 x $5 is $2250 twelve months = $27,000. If one is sending out 1000 statements per month, something I’m sure that a large business could easily accomplish, the expense can be $60,000 in the assumption of a cost of $5.
If your patient’s statements cost you at least $27,000 each year, why aren’t you determined to get rid of them altogether?
A payment portal online for patients is a possibility designed to cut down on the number of bills sent out every month. Patient payment portals online can assist in making the bills clearer and more understandable for patients. This reduces the anxiety patients feel upon receiving a statement. Online payment portals also increase the time taken to an office to be able to accept a check. Patients are used to paying their bills online these days. If you’re not offering an online payment option for patients, you’re affecting revenues.
Confirm Billing and Coverage Information
It is a simple matter to confirm the patient’s coverage and billing details prior to the first patient visit could make a huge impact on collections. For instance, Children’s Orthopedic & Scoliosis Surgery Associates utilized software for managing practices to verify the coverage of patients and to check for issues like pre-authorization requirements.
In doing this the patients were paid faster and reduced average days for accounts receivable, and even had a better rate of clean claims. The confirmation of coverage and preauthorization is yet another way to improve the clarity of the billing process for patients.
The process of updating your billing to handle the growth in health insurance plans with high deductive benefits isn’t always a matter of expensive devices or an intricate method. It’s usually as easy as teaching the front desk staff to verify coverage and having discussions about payment policy and finances with patients.
Stop Making Bills Complicated
A majority of people would like to pay for their medical expenses however, they aren’t sure how to pay the implications of these. They might, for instance after an emergency visit, wait around for the bill or explanation of the benefits to be delivered and then attempt to understand the whole thing. But this can be quite complicated for the average individual.
The majority of people need to know what they owe as well as what they’re paying for, as well as any action that providers implement to help them will boost collections rates. If clients feel confused or cheated or feel that they don’t have a voice and their needs, they’re less likely to pay their bills on time and fully.
Are there staff members at your practice who are devoted to answering questions from patients regarding insurance statements, statements, etc.? It’s not often. isn’t considered to be a “must-have position” in medical practice but it could yield real results for patient satisfaction and the ability to pay bills on time.
Offer Financial Counseling
Many practices offer financial counseling to ensure that high-deductible policyholders, as well as self-pay patients, can get an understanding of the obligations they have to fulfill at the beginning and their options for meeting their obligations.
Most of the time, the financial counseling that is offered is usually only utilized at the end of the billing process; however, it makes sense to provide counseling earlier during the process of the Revenue Cycle, and letting the patients know what they can anticipate and how to pay for their costs. The counseling offered when patients have become overwhelmed and confused is more likely to not yield the outcomes that hospitals and other providers would like.
Patient co-pays comprise around 20 percent of a practice’s income, yet practices can only collect about 60 percent of co-payments. In the event of delays in collecting co-payments, it results in lower rates of the collection which is why it’s important to create strategies for quick payment collection and to inform patients about how the process can be handled as early as possible.
