How To Improve Patient Collections Easily

Reading Time: 4 minutes

Are you struggling with outstanding account receivables? Did you know that research shows practices only collect about 12% of outstanding balances at the time of service and collect nothing approximately 67% of the time? Also, it has been shown that the higher the outstanding balance, the less monies are collected. For example, about 40% of outstanding balances are collected for the amount of $35 or less; but that percentage falls to 6% for balances over $200. Although only 20% of visits have a balance of $200 or more, they account for 73% of all outstanding revenue. That adds up quickly!

Although the Affordable Care Act opened up access to health care coverage to more Americans, insurers are moving toward higher deductibles and co-pays, pushing more financial responsibility toward the patient. This trend from insurance companies can cause sticker shock and put patients in a position of receiving a medical bill they are unable to pay.

improve patient collections

Medical Billing and Collections

The medical billing process can be overwhelming and feel nearly impossible but is critical to your practice’s financial health. By improving the billing workflow, you will increase your income and improve time management.

You may be thinking; there is always the option of turning them over to collections. However, this should be done as a last resort. Turning a patient over to a collection agency won’t get you the entire amount you are owed, as patients may not pay the total amount to the agency. On average, these agencies take 40 – 50% of the amount collected as commission. In the end, you could get as little as 12% of the balance as revenue, and the public relations aspect of this is terrible.

It is more important than ever for practices to stay abreast of patient billings and balances to ensure their financial health. Creating a more accurate billing process can relieve stress on you, your office staff and foster patient trust.

How to Reduce Patient Balances Upfront

The best option in managing you’re A/R is to collect as much as possible from a patient at the time of service.  Here are some tips on how:

  • Eligibility – contact the patient’s primary and secondary insurer (payer) to get exact information on deductibles and co-pay amounts due at the time of service for the type of service and collect upfront
  • Fee Schedule – have a fee schedule available for the front desk, so they know how much the patient portion will be if they have not met their deductible
  • Train staff – ensure your staff knows how to approach and discuss the patient’s financial responsibility either for that specific visit or for any outstanding balance when they are at the office
  • Strict payment policy – have a policy that is tailored to having patients pay full responsibility for the visit as well as some payment from the previous balance before providing any additional service
  • For specialists – have a patient coordinator who can explain all out-of-pocket expenses to the patient to ensure they can pay in full at the time of service or set up a payment plan at that time

Medical Billing Collections due

How to Handle Outstanding Patient Balances

Although a practice needs to come to terms with the fact that some patients will always have an unpaid balance, there are strategies you can use to help improve your patient collections:

  • Credit card – ask patients to keep a credit card on file with a signed consent form to be able to charge any outstanding balances automatically
  • Don’t just mail statements – utilize text and email to communicate with your patients on any outstanding balance
  • Utilize technology – make it easier for patients to pay through your website, portal, on an app, or by phone and accept debit and credit cards along with checks and cash
  • Offer a payment plan – larger amounts incurred due to expensive procedures, such as surgery, may need to be broken up into payments the patient can manage, ensuring you get paid in full eventually
  • Personal touch – have a patient coordinator who can call and discuss the outstanding balance with the patient and work out how to get the balance paid
  • Have a strict collections policy – send the outstanding debt to collections as a last resort

The goal is to collect more patient payments with less delay. While you are in the healthcare business to help people, your practice is still a business, and you have financial responsibilities of your own that have to be met.

Get Help with Patient Collections

If you are struggling with efficiently collecting patient balances, an outsourced medical billing company can help!

At Billed Right, our team of medical billing professionals can help increase your revenue while lowering your costs.  We are experts in revenue cycle management and work directly with your staff and PMS to ensure your practice is collecting the most revenue possible. We offer help with eligibility verification, account receivable follow-up, patient collections, and much more!

Contact Billed Right today to see how we can help you increase your revenue!

Difference Between Medical Billing and Revenue Cycle Management

Reading Time: 4 minutes

In-house Medical Billing

Initially, physician’s offices had a person in-house that handled everything having to do with billing for the practice. This person added to the overhead of the office – about 10 – 12% and handled everything from A-Z in the billing process. General knowledge of codes was all that was needed to ensure reimbursement from insurance companies as this was before managed care.

The beginning of managed care brought to the industry fee schedules, preferred provider contracts, the need for pre-authorizations, and more. These changes meant a more intensive knowledge of medical codes was required as well as continuing to keep updated as codes were added and deleted.  These changes increased the cost and time required to handle billing.

Outsourced to Medical Billing Companies

A couple of decades ago, medical billing companies came onto the scene. Someone realized they could do all of the medical billing for multiple doctors saving the doctors time and money.  This service included submitting claims, working with denials, and getting doctors paid by the insurance companies.

One of the biggest issues came in because now the doctor had to deal with more than one person. There was the office manager, consultant, credentialing, and finance/business development – all separate but necessary parts of the whole process. Along with that were some stumbling blocks – there was no verification, documents had to be scanned and provided to the medical billing company and these companies didn’t work within the doctor’s internal system. The cost was around 8 – 10%.

Revenue Cycle Management for Healthcare

After listening to what clients were asking for, a more robust system was created that covered more than just standard medical billing. This full-cycle revenue management system saved doctors time and money by eliminating the need to have different people handling all other aspects. Revenue Cycle Management includes:

  • Insurance Eligibility – insurance verification and patient eligibility details checked two days ahead of a patient’s appointment ensuring 100% upfront collection.
  • Charge Posting – ensuring demographic information is entered in the system accurately helping to eliminate rejections or denial from the payer which can prolong the reimbursement turnaround time
  • Documentation Review – once visit notes are locked coding team retrieves a random sampling of the weekly visits to review and ensure proper guidelines were followed. We also provide education to the doctor and staff on their usage of CPT/ICD -10 to help them improve on future documentation.
  • Claim Submission – claims are reviewed and scrubbed to ensure that all information in the claim is correct to help eliminate a denial.
  • Denial Management – when payment for services is denied, we follow up with the insurance carrier to determine if it is a coding error or something else that has facilitated the denial. We complete appeals and add any supporting documentation submitted through your software.
  • Payment Posting – critical to the health of your AR – insurance payments posted to patient accounts from EOB’s in the doctor’s system with a turnaround time of 24 to 48 hours. With daily payments accessible via the practice management system.
  • Account Receivables – a team assesses AR, runs any reports necessary to determine those claims that have outstanding action, and organize them accordingly. Providing follow-up notes on claims within the software for full transparency.
  • Patient Collections – we send out monthly statements for outstanding balances and actual take calls from patients with questions on their bills.
  • Authorizations ­– we can handle obtaining pre-authorizations in a variety of formats including online forms, faxing request forms from the client’s Practice Management System, or through telephone notification to the payer.
  • Credentialing – with experienced credentialing specialists we can ensure that all information required is obtained from the practitioner and even complete all enrollment forms for insurance carriers.
  • Coding – coders start by reviewing visit notes once they are locked and ensure procedure codes and ICD codes are accurate and reflect documentation. The notes are also scanned for any modifier that may be needed and everything is quality checked for completeness and accuracy.
  • Contract Renegotiation ­­­– this can take a large toll on the revenue of a practice. We have a team that can analyze current reimbursement rates and determines which contracts need to be renegotiated.
  • Documentation Management – many office staff is drowning in administrative tasks. Helping with document management by handling incoming faxes and ensuring they are assigned to the correct patient charts saves both time and money.
  • Reporting – providing full transparency through the entire process by providing weekly, monthly, quarterly and annual reports.
  • Account Management – every client is provided with a dedicated account manager who can be contacted with any questions and will see they are answered promptly.

 

As you can see, the above list of services goes way beyond the standard medical billing company and offers a truly holistic medical billing service option for physician offices of any size. In addition to the cost and time-saving benefits here are a few more:

 

  1. Transparency – The entire workflow is documented in the software and can be accessed by you at any point. Having transparency in all the work, expectations, and communication allows you to be better informed and in control.
  2. Fewer Errors – With professionals working in one system, using technologies to scrub and audit claims you can rest easy knowing your data is being properly input and accurate.
  3. Reduced Costs – With fewer errors comes reduced costs. You may think it’s less expensive to keep billing in-house and try to perform the details of RCM with your current staff. The data shows this is not the case. Offices that hire a company to manage their revenue see an increase in reimbursement as well as a decrease in staffing costs. 4. Work Within Existing Systems – Unlike medical billing companies RCM can work within existing EMR/EHR software.

How to optimize healthcare revenue cycle

At Billed Right we provide RCM Solutions to help doctor’s practices grow. We understand that every practice is unique and therefore deserves a personalized strategy that works to improve patient care and increase practice revenue. Our goal is to not only ensure your practice gets paid but to be a strategic partner who will maximize your practice to its fullest financial potential.

If you want to begin saving money or have any questions and want to speak to a medical billing consultant contact us today!