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How Many Opportunities Are Passing You to Collect?

Insured patient costs have increased 256 percent between 2004 and 2014 according to a survey in 2016 by The Henry J. Kaiser Foundation. Assist your patients and team to quickly obtain payment and successfully close accounts while boosting patient satisfaction and overall experience.       
 
Know Thy Patient 
This means to find out everything possible about the patient at the VERY front end of the revenue cycle. This includes their deductible amount, whether the patient has an HSA or other type of flex spending account and other factors that provide knowledge about the patient's ability to pay. Integrating billing systems with your EHR can help staff to remind the patient when the payment is due. 

Be a Retailer 

Consider retail-centric principles to collect more money. An example of this is to have friendly, outgoing personalities at the first point of patient contact who are effective at asking for money (and will ask!). While 75% of medical businesses can provide a cost estimate at or before the time of service, only about 25% of patients requested one at their last visit based on 2017 survey results from HIMSS Analytics. Dental offices are great at deploying this method regardless if the patient asks and then setting a patient's financial obligation before s/he receives the first patient balance statement. 
Establish expectations for front desk staff to collect outstanding balances at the time of service. In fact, this is the first thing that should be done. Teaching with scripting or role playing techniques can make your handpicked front desk staff comfortable in this role. 

The same survey also found that 79% of patients feel comfortable sharing their email address and receiving secure electronic notifications. This can save hundreds to thousands with a quick return on technology investment after incorporation of this method.   
 
Multiple Payment Channels 
  • Obtain a deposit at the time of scheduling for large cost services and procedures. 
  • Invest in an add on application to estimate a patient's ability to pay. For example, based on the result for Mrs. Smith, it's determined of her $500.00 bill, she can only pay $200.00 right now. Obtain that payment and set the remainder on an automatic payment plan. 
  • Regarding payment plans: ensure your system notifies the appropriate parties when a payment is missed so follow up can be done right away. If the plan was not an automatic one, be sure to set one up now! 
  • Accept every credit card type possible. Regularly monitor credit card processing fees and solicit new bids to compare rates. 
  • Offer online payments: direct patients to a URL link, ability to make a mobile payment and or set up an Interactive Voice Response (IVR) system to handle callers via an automated telephone-payment system to make e-check, debit and credit card payments 24/7. Be sure to thoroughly test the system and how it responds prior to roll out! 
  • Have a Credit Card on File (CCOF) process. According to the same survey mentioned above, more than 78% of patients said they would provide their debit or credit card number to be charged one time up to $200.00 after an insurance payment was processed. This strategy alone can reap revenue and reduce the cost of collections. 
  • Collaborate with your team to develop additional convenient payment strategies. 

Success Stories


Average bill age when our office received: 180 days plus BALANCE: $ 1,233.00 PROBLEM: Claim denied needing primary EOB. SOLUTION: Claim billed to supplemental policy instead of MMAI policy which was effective for service date.
Average bill age when our office received: 180 days plus BALANCE: $ 2,176.00 PROBLEM: Claim denied because of no insurance coverage for service date. SOLUTION: Claim was filed to incorrect claims address.
Average bill age when our office received: 180 days plus BALANCE: $ 1,013.50 PROBLEM: Claim denied because of insurance ID mismatch. SOLUTION: Claim filed to traditional plan vs. community care.
Average bill age when our office received: 180 days plus BALANCE: $ 1,203.00 PROBLEM: Patient disputed charge/balance owed, comparing it to a similar past bill. SOLUTION: Explained itemized charges and balance owed because of deductible. Patient stated first time someone took the time to explain and set up a payment plan.
Average bill age when our office received: 180 days plus BALANCE: $ 1,007.50 PROBLEM: Denied by hospice as non-eligible benefit and Medicare as ID name mismatch. SOLUTION: Verified/corrected Medicare ID, name and date; confirmed hospice non-eligibility.
Average bill age when our office received: 180 days plus BALANCE: $ 1,305.00 PROBLEM: Denied no pre-authorization for service. SOLUTION: 3-way call with patient and insurance. No ER report on file when claim originally submitted. ER report since received.
Average bill age when our office received: 180 days plus BALANCE: $ 1,001.50 PROBLEM: Denied with "misrouted" and "claim not covered by payor". SOLUTION: 3-way call with patient and insurance. Claim was related to mental health so should have been filed through carve out policy.
Average bill age when our office received: 180 days plus BALANCE: $ 1,755.00 PROBLEM: No response from insurance after requested records submitted. Patient stated insurance paid. SOLUTION: Billing office did not receive/post insurance payment. Called insurance and records received but claims representative had not released for processing.
Average bill age when our office received: 180 days plus BALANCE: $ 4,540.50 PROBLEM: Multiple bills, same service dates as claims already paid. Denied due to no pre-authorization for service. SOLUTION: Call to insurance who verified no pre-authorization requirement. Two claims not found. To prevent duplicate denial upon resubmission, account rep notated resubmission for return transportation trip. Proof of timely filing submitted with claims.
Average bill age when our office received: 180 days plus BALANCE: $ 1,180.00 PROBLEM: Denied due to no pre-authorization for service. SOLUTION: 3-way call with patient and insurance. Claim should have been sent directly to IPA vs. umbrella insurance location.
Average bill age when our office received: 180 days plus BALANCE: $ 1,117.00 PROBLEM: Unpaid due to incomplete demographic information. SOLUTION: Contacted pick up and drop off locations. Sent release to obtain information and patient’s name misspelled.
Average bill age when our office received: 180 days plus BALANCE: $ 1,605.00 PROBLEM: Denied due to medical necessity. SOLUTION: 3-way call with patient and insurance. Spoke with multiple reps and received different answers including claim not found. Claim was found with no response from medical board. Patient had to submit medical records.
Average bill age when our office received: 180 days plus BALANCE: $ 1,007.50 PROBLEM: Denied multiple times as duplicate. SOLUTION: Located claim number ID, amount paid and date paid. Claim had already been paid in full but not posted.
Average bill age when our office received: 180 days plus BALANCE: $ 1,650.00 PROBLEM: No insurance on file. SOLUTION: Pick up location was state prison. Located inmate ID and could be billed to prison insurance as still within timely filing limits.
Average bill age when our office received: 180 days plus BALANCE: $ 2,295.50 PROBLEM: Denied as “forwarded to another entity for processing”. SOLUTION: Called insurance for medical group processing information. They did not have claim on file. Resubmitted with proof of timely filing.

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