By Alex Tate
Medical practices need to be very careful about their billing. A relatively weak billing department not only impacts revenues but also leads to patients who are not satisfied with the service, which ultimately affects your practice’s reputation. Hence the business end of the practice should be a top priority for any practicing doctor.
We at CureMD realize that doctors are not accountants. Thus, this article has no billing jargon or complicated algorithms for improving revenue cycle management. Just remember—not to concentrate all your energies in collecting from insurances. Maximizing patient collections should be a priority.
Around 30-32% of a small practice’s revenue comes through patient collections a recent study by MGMA indicated. Furthermore, with more professional organizations purchasing high deductible and lower premium insurance plans, the burden to pay is shifting towards the patient.
Unfortunately, the difficulty arises in collecting from patients, and hence most of it remains unpaid. Many experts have suggested that practices might be losing a huge amount of money by simply not following up on patient collections. The following tips which are easy to implement will go a long way in helping you collect from patients. Try them and share your feedback with us.
1. Collect maximum at the time of service
As time passes the probability of successfully collecting patient balances decreases, hence practices should try to collect the maximum amount possible from patients at the time of service.
Practices are able to collect from:
- 90% of patients at check in
- 70% of patients at check out
- 40% of patients after they have left the practice
- Collect co-pays at the time of check-in rather than checkout.
- A day before the appointment to make certain that the patient is still covered and also to receive information about deductibles, verify insurance eligibility 24 hours before the appointment. If a patient has a remaining deductible balance, encourage them to pay you themselves rather than sending claims to the payer.
- A claim estimator is very helping in helping you figure out the amount owed to you, and this can then lead to a discussion about the collection cycle before performing a surgery or medical procedure. Every payer has a claim estimator on their website.
Collecting upfront will not only increase the amount of collections but also cut down the cost of reaching out to the patient after they leave the front desk i.e. mailing billing statements, making calls etc.
Besides, it also helps to save time and labor, and allows practices to spend more time on patient care.
2. Install a credit card payment system
Billing on credit card will be beneficial in the long run, as you can save credit card details and automatically bill the patient once the insurance company processes the claims.
Moreover, many people actually prefer paying by credit cards and avoiding the hassle of carrying cash with them at all times. Therefore, billing through credit card will also be a customer friendly addition to your practice.
3. Report “professional debtors” to the payer
You know those patients, the ones who are considered “professional debtors,” the ones that will never pay? They will pay a minimum amount, every three months, to stay out of collections. They call your staff and remind them that they are “long term patients,” and ask, “How could you send me to collections?”
You send such patients three statements, and still receive no payment. You might even experience a phone call where they yell at your front-office staff or the billing department.
Your next course of action should be to call the specific insurance company and report the patient. Yes, this is your right and business responsibility. Each insurance company has their own process; you just have to ask.
Many insurance companies will ask you to send them an appeal letter stating the patient details and your efforts to reach out to them. Once verifying the appeal, the insurance company sends out a letter to the patient, instructing them to pay the bill. If the patient still does not pay, the insurance company will ultimately have to pay you the money and then adjust the amount on the patient’s deductible balance.
4. Improve customer support at the billing side
Since the first point of interaction between the patient and the practice is the front desk in most cases. It is necessary that the front desk and billing staff is able to provide excellent customer service to the patients. The billing staff should be aware of the insurance details of patients when they come for their visit. Not only will this avoid delays, but it can help collect at the time of service. The staff should understand and resolve issues related to patient registration and creating the right charge so that when the information reaches the billing staff, there is no error that may result in denial of claims.
One of the most important jobs of the front desk staff is to take down correct patient information including demographic and insurance card details. Having an ill-equipped front desk from lack of training will directly affect the billing staff and their work load. This will make them step in and take correct information and mention the correct code before making the claims. Such a practice would avoid claim rejection and delays in money transfer due to incorrect information.
To avoid such issues, doctors should hire people whose expertise lie in medical billing and are familiar with medical terminologies or hire professionals with can-do attitude and train them in medical services.
Adopt EHR system to make billing efficient
One of the benefits of adopting Electronic Health Record system is that it streamlines a practice’s billing operations. Once the staff is trained in an EHR system, they are able to cut down mistakes while taking down patient information that will help to create accurate claims, which means the insurance money will be billed on time.
In order to avoid the hassle of different software for managing billing and clinical records, practices can opt for an integrated solution offered by CureMD that contains EHR and Practice Management in one package.
Save time and money by outsourcing billing
Physicians neither have time nor are they trained in management skills to look after their billing. They can outsource medical billing to vendors that helps practices obtain maximum insurance money and review their billing processes continuously to stay on top.
CureMD offers not only billing services but a free EHR and Practice Management system, charging as low as 4% on annual collection, and at the same time taking care of all your billing requirements, so you can practice without the hassle. The only thing you have to do is enter the correct information on the EHR and send it to our billing consultants who will manage your entire billing cycle for you.
Alex Tate is a health IT fanatic who is passionate about technology and its revolutionary impact on the healthcare industry. He adds value to the healthcare community by providing answers to problems faced by the providers. He is always hunting hot topics and opportunities that will open new dimensions in the field of Health IT.