Consider the following four facts:
- On average, patients receive three statements before they pay medical providers
- Self-pay has increased to close to 40% of the gross revenue of each provider
- You never collect 20% of that gross revenue
- 32 million more patients will be insured by either Medicaid or other insurance in 2011
Now and in the foreseeable future, you have change being thrust upon you. Think about EMR requirements, red flag compliance, changing Medicare and Medicaid processing procedures, changing payer remittance procedures and HIPPA . All or some of these changes will require stricter and more expansive auditing.
Those kind of massive changes will exacerbate a common problem, especially in this economy, that most of you struggle with.
Collecting money.
Your current model bills retroactively, and pays and submits claims the way the insurance companies prefer business to be done. The system simply was not designed to handle high-risk payers which is what your patients are.
You see the results of these revenue collection practices each day—in seeing more patients in order to meet expenses, working more hours, freezing the wages of your staff and even laying off staff.
This, of course, ends up reflecting in the quality of patient care.
The only answer to these challenges of collecting revenue is to collect money at the point of care. Unfortunately, this is something that most providers do not do well. Just like other businesses, you need to establish what the patient owes before they leave the facility and get paid or arrange for a payment plan at that time.
A good medical billing system, designed to collect at the point of care, can be a great help.
Medical Practice Technology
What a medical practice needs from technology is:
- Automatic Payments- Pre-authorized payments that flow directly from the patient’s checking account or credit or debit card
- Statements- A document that details an EOB or provides a line item statement of monies owed
- Balance- This should include remaining coinsurance, co-pay and deductible while providing a complete financial balance
- Eligibility- Instant determination of eligibility prior to the service being rendered
You either have to procure the systems and staff to do this yourself or outsource it to a competent medical billing firm that already has it in place. No, outsource is the wrong word. The word is partner. Because the medical biller you choose to make sure the cash is flowing into your business, has to be a true partner with your practice.