Historically, family practices and many other physicians groups have routinely waived insurance copays as a gesture of goodwill to patients in a tight economy. After all, who wants to hound sick patients for their portion of the charges?
There was a time when insurance companies turned a blind eye to these routine waivers of copays. Not anymore.
The AMA's Code of Medical Ethics Opinion 6.12 explains why routine waivers are unethical, particularly when a clinic advertises a willingness to waive copayments.
Further, the Office of Inspector General (OIG) has long taken the position that routine waiver of copayments constitutes an illegal kickback, which is a felony.
The routine waiver of copayments also constitutes a violation of the terms of private insurance company plans. This contractual violation serves as a basis for a recoupment audit, during which insurance companies request proof of collection of copayments for five randomly selected patients. If the clinic cannot prove it collected, or at least exhausted all reasonable means of collection, then the carrier may demand a refund for any benefits paid across a large patient population.
Perhaps most frighteningly, routine copay waivers constitute ordinary financial fraud. If a patient is charged $100 and the insurance carrier is billed $80, the patient is supposed to pay $20. If you never attempt to collect the $20, this means the actual charge is $80, not $100. Therefore, the insurance company should only pay $64 (80 percent of the $80
Fraud or dishonesty is a primary way to get in trouble with state medical boards.
There are provisions for waiving copayments in cases of financial hardship. At a minimum, you should document the financial hardship, and obtain a release from the patient to turn the financial document over to the insurance company, if requested.
The OIG states the following criteria for waiver on the basis of financial hardship:
• The waiver must be based on a good faith determination of the patient’s financial need. In other words, waivers must not be applied routinely. The government does not specify the financial status that would justify a waiver, so you should develop your own approach, apply it consistently, and document your efforts. For example, if your efforts to collect on a patient’s bill fail, or if it’s obvious that a patient is struggling to pay the amount owed, ask the beneficiary to fill out a form noting their employment status and average household income and expenses. Then make your determination based on the information provided.
• The waiver must not be based on the amount of the charges. Your decision about whether to waive what a patient owes should be based on the patient’s ability to pay without regard to what Medicare may have paid or the total charges for the service.
• The waiver must not be offered as part of an advertisement or solicitation.
State laws vary regarding waivers. Therefore, seek the advice of an experienced health lawyer in your state if you have questions about your practices.
Article By Martin Merritt from Physicians Practice
http://www.physicianspractice.com/blog/medical-practices-think-twice-before-waiving-copays?GUID=2E8F906E-CDE7-43B7-AC93-7066F83372C7&rememberme=1&ts=19112013
Showing posts with label accounts receivable. Show all posts
Showing posts with label accounts receivable. Show all posts
Friday, November 22, 2013
Monday, November 4, 2013
Improve Patient Education to Improve Medical Practice Collections
Often patients misinterpret how, and how much, they will be billed for their visits.
Take for example, the copay. When patients pay a copay at time of service, they sometimes believe this is all they will owe. So when they receive a bill in the mail a few weeks later, they complain. They call and say something like, "I was told I only had a $10 copay, and that's ALL I am paying!”
Addressing a patient concern like this one takes up staff time and hinders the collection process. Staff may feel so bad when speaking with a patient that they may even adjust off the patient's balance.
Problems due to payment misinterpretations, however, are avoidable if your front-office staff spends a few minutes prior to a patient's appointment explaining how the billing process works.
A front-office person should come out to the lobby, sit with the patient, and explain each policy the patient will need to sign, including your practice's privacy policy, payment policy, and cancellation policy. This will indicate to the patient that he is valued and cared for.
Explaining the payment policy and how benefits work in a calm and professional manner will provide the patient with a much greater understanding of how his policy works. Over the years I have seen firsthand how many patients have a poor understanding of these important elements. Although this one-on-one patient explanation might seem like a concierge-type service, it's a sound investment to make in your practice.
Patients will no longer misunderstand how payment works, and they will have a greater understanding of insurance. That of course, will translate to more streamlined patient collections.
Patients will also have a better understanding of their benefits, which means they will understand when billing questions and complaints should be directed to insurers, rather than to your practice. With all of the insurance exchanges marketing to patients; and the print, electronic, and television ads touting “affordable plans” to your patient population, it is more imperative than ever to spend the time explaining patient benefits clearly.
Consider the time spent explaining payment and benefits to your patients as part of your customer service package. Train your front-office staff to step out from behind the desk, sit with the patient, answer any question, and build rapport. You won't be sorry.
Article By P.j. Cloud-moulds of Physicians Practice
http://www.physicianspractice.com/blog/improve-patient-education-improve-medical-practice-collections?GUID=2E8F906E-CDE7-43B7-AC93-7066F83372C7&rememberme=1&ts=01112013
Take for example, the copay. When patients pay a copay at time of service, they sometimes believe this is all they will owe. So when they receive a bill in the mail a few weeks later, they complain. They call and say something like, "I was told I only had a $10 copay, and that's ALL I am paying!”
Addressing a patient concern like this one takes up staff time and hinders the collection process. Staff may feel so bad when speaking with a patient that they may even adjust off the patient's balance.
Problems due to payment misinterpretations, however, are avoidable if your front-office staff spends a few minutes prior to a patient's appointment explaining how the billing process works.
A front-office person should come out to the lobby, sit with the patient, and explain each policy the patient will need to sign, including your practice's privacy policy, payment policy, and cancellation policy. This will indicate to the patient that he is valued and cared for.
Explaining the payment policy and how benefits work in a calm and professional manner will provide the patient with a much greater understanding of how his policy works. Over the years I have seen firsthand how many patients have a poor understanding of these important elements. Although this one-on-one patient explanation might seem like a concierge-type service, it's a sound investment to make in your practice.
Patients will no longer misunderstand how payment works, and they will have a greater understanding of insurance. That of course, will translate to more streamlined patient collections.
Patients will also have a better understanding of their benefits, which means they will understand when billing questions and complaints should be directed to insurers, rather than to your practice. With all of the insurance exchanges marketing to patients; and the print, electronic, and television ads touting “affordable plans” to your patient population, it is more imperative than ever to spend the time explaining patient benefits clearly.
Consider the time spent explaining payment and benefits to your patients as part of your customer service package. Train your front-office staff to step out from behind the desk, sit with the patient, answer any question, and build rapport. You won't be sorry.
Article By P.j. Cloud-moulds of Physicians Practice
http://www.physicianspractice.com/blog/improve-patient-education-improve-medical-practice-collections?GUID=2E8F906E-CDE7-43B7-AC93-7066F83372C7&rememberme=1&ts=01112013
Friday, October 25, 2013
Boost Medical Practice Collections by Cutting Down Patient Statements
By P.j. Cloud-moulds from Physicians Practice
Do you know how many patient statements are sent out at your practice? Do you know how high that A/R class is? These are two very important questions you need to ask yourself today. The numbers might shock you.
If you do find that the number of patient statements is too high, you can then start asking why this is the case. Here are some of the common reasons:
Your front office staff did not collect the patient copay, coinsurance, or deductible. If you have an up-to-date fee schedule, calculating the patient coinsurance and deductible is easy, and should be done at the end of the appointment prior to the patient walking out the door. Copays are easy to collect and should be collected at the beginning of the appointment.
Your front-office staff did not collect according to plan details. When verifying an insurance plan, sometimes the insurance company will provide incorrect information. Your staff may also be calculating the patient portion incorrectly. Be sure your staff is well trained in this area. It's costing you a lot of money if they are not.
Patients are paying at the time of service, but those payments are not getting posted properly. This results in a nasty call from the patient stating that, “I paid, and will not pay again!” This is the epitome of poor customer service. Institute checks and balances at the end of each day to ensure payments are posted.
Patient “forgot their checkbook or credit card.” This is a line that you hear too often, and it's full of hot air. If the patient “forgets,” let him know that he can call in his payment by the end of the day, or he will incur a late payment fee. Yes, this is legal. If the patient can't pay now, he certainly won't pay in a month when he gets the bill.
Staff adjusts off a patient deductible. Your front-office staff performs the insurance verification, and sees that the patient has a $5,000 deductible of which only $352 has been met. Once the deductible is met, the patient is responsible for 20 percent of the allowed charges. Your front-office staff is reluctant to charge the patient the deductible amount for fear of being yelled at by the patient (who should already know her plan limitations, but most often does not) so staff charges her the co-insurance instead. This results in the patient getting a bill for the remaining amount. The angry patient then calls and yells at the staff stating, “I paid at the time of service!” Another example of poor customer service. Remember, you cannot adjust off a patient deductible.
The patient has Medicare and a secondary insurance. Since we are not allowed to collect monies from Medicare patients until Medicare pays its portion, we bill the secondary. If the secondary does not pick up all of Medicare's 20 percent, then the patient gets a bill. It's really difficult when some Medicare patients do not understand their secondary insurance has a deductible, or will not cover the entire 20 percent.
Just sending out statement after statement is a very poor way of running a business. Have a time limit of how many statements you will allow a patient to receive. Three months is a good rule of thumb. If patients need to be put on a payment plan, that's great, but put a time limit on that, as well. Your practice is not a bank, credit union, or credit card. It is a business, and no other business would allow goods and services to walk out the door before payment. Stop allowing patients to take advantage of your good nature.
Article taken from Physicians Practice http://www.physicianspractice.com/blog/boost-medical-practice-collections-cutting-down-patient-statements?GUID=2E8F906E-CDE7-43B7-AC93-7066F83372C7&rememberme=1&ts=22102013
Do you know how many patient statements are sent out at your practice? Do you know how high that A/R class is? These are two very important questions you need to ask yourself today. The numbers might shock you.
If you do find that the number of patient statements is too high, you can then start asking why this is the case. Here are some of the common reasons:
Your front office staff did not collect the patient copay, coinsurance, or deductible. If you have an up-to-date fee schedule, calculating the patient coinsurance and deductible is easy, and should be done at the end of the appointment prior to the patient walking out the door. Copays are easy to collect and should be collected at the beginning of the appointment.
Your front-office staff did not collect according to plan details. When verifying an insurance plan, sometimes the insurance company will provide incorrect information. Your staff may also be calculating the patient portion incorrectly. Be sure your staff is well trained in this area. It's costing you a lot of money if they are not.
Patients are paying at the time of service, but those payments are not getting posted properly. This results in a nasty call from the patient stating that, “I paid, and will not pay again!” This is the epitome of poor customer service. Institute checks and balances at the end of each day to ensure payments are posted.
Patient “forgot their checkbook or credit card.” This is a line that you hear too often, and it's full of hot air. If the patient “forgets,” let him know that he can call in his payment by the end of the day, or he will incur a late payment fee. Yes, this is legal. If the patient can't pay now, he certainly won't pay in a month when he gets the bill.
Staff adjusts off a patient deductible. Your front-office staff performs the insurance verification, and sees that the patient has a $5,000 deductible of which only $352 has been met. Once the deductible is met, the patient is responsible for 20 percent of the allowed charges. Your front-office staff is reluctant to charge the patient the deductible amount for fear of being yelled at by the patient (who should already know her plan limitations, but most often does not) so staff charges her the co-insurance instead. This results in the patient getting a bill for the remaining amount. The angry patient then calls and yells at the staff stating, “I paid at the time of service!” Another example of poor customer service. Remember, you cannot adjust off a patient deductible.
The patient has Medicare and a secondary insurance. Since we are not allowed to collect monies from Medicare patients until Medicare pays its portion, we bill the secondary. If the secondary does not pick up all of Medicare's 20 percent, then the patient gets a bill. It's really difficult when some Medicare patients do not understand their secondary insurance has a deductible, or will not cover the entire 20 percent.
Just sending out statement after statement is a very poor way of running a business. Have a time limit of how many statements you will allow a patient to receive. Three months is a good rule of thumb. If patients need to be put on a payment plan, that's great, but put a time limit on that, as well. Your practice is not a bank, credit union, or credit card. It is a business, and no other business would allow goods and services to walk out the door before payment. Stop allowing patients to take advantage of your good nature.
Article taken from Physicians Practice http://www.physicianspractice.com/blog/boost-medical-practice-collections-cutting-down-patient-statements?GUID=2E8F906E-CDE7-43B7-AC93-7066F83372C7&rememberme=1&ts=22102013
Friday, September 6, 2013
Revenue Cycle Management Is More Than Billing Patients
Revenue cycle management (RCM) is the lifeblood of any practice — private or nonprofit. Effective patient registration, insurance and benefit verification, charge capture, and claims processing are essential to maintaining practice viability. Before you can improve any process, you need to assess where you are now. Here are some questions you should think about:
• Do you know if you are achieving best practice standards in accounts-receivable management? • Does it take your practice too long to collect, and/or are your write-offs and adjustments too high? • Do you know your claim-denial rate on first submission (4 percent of claims or fewer is best practice)? • Have you determined that you are not leaving any money on the table with a reimbursement analysis? • What are your days in A/R? What percentage of your accounts receivable is more than 120 days old (10 percent or less is best practice)?
Patient registration The revenue cycle starts with patient registration. Patient registration begins with a phone call for an appointment request. Your front-desk staff should interview the patient on the phone to collect billing and insurance information; invite the patient to go online to your website to complete their registration information; and follow up if registration isn't completed two days prior to the appointment — so that the patient's insurance coverage can be verified. You can use an in-office kiosk for patient check in and to collect demographic information. Some kiosks will automatically verify insurance eligibility too. Charge capture Transferring patient charges from the EHR to your practice management (PM) system should be seamless — electronically transmitting data is an example of efficient workflow. But, if you are forcing your providers to first complete a paper visit-encounter form, and then transfer that information to the EHR, it can lead to inconsistencies, lost data, and redundant work processes. Furthermore, asking your check-out station to compare electronic patient information against the paper encounter form is burdensome and creates even more work when discrepancies arise. Automatic payment posting Automatic payment posting can significantly reduce staff work, so why don't more billing staff embrace and drive implementation of auto-post opportunities? Holding tight to the status quo — manual payment posting and reconciliation — is an inefficient use of our most costly resource: staff. Routinely ask your payers, clearinghouses, and software vendors about new services coming online, and roll out every new payer as electronic remittance and auto-posting become available. Investigate a bank lockbox service that converts the paper explanation of benefits (EOBs) to electronic transactions (837s) for automatic posting to patient accounts. Insurance eligibility verification Investigate and incorporate automatic insurance eligibility verification into your work flows. You can use your clearinghouse service to upload the appointment schedule a couple of days in advance, in a batch process. For walk-in patients, use real-time verification through your PM system. An integrated verification solution creates a history within the patient's record that supports follow-up collection efforts, if there are later discrepancies with the payer.
Article by Rosemarie Nelson - See more at: http://www.physicianspractice.com/billing-and-collections/revenue-cycle-management-more-billing-patients?GUID=2E8F906E-CDE7-43B7-AC93-7066F83372C7&rememberme=1&ts=29082013#sthash.Bbvb2ywQ.dpuf
• Do you know if you are achieving best practice standards in accounts-receivable management? • Does it take your practice too long to collect, and/or are your write-offs and adjustments too high? • Do you know your claim-denial rate on first submission (4 percent of claims or fewer is best practice)? • Have you determined that you are not leaving any money on the table with a reimbursement analysis? • What are your days in A/R? What percentage of your accounts receivable is more than 120 days old (10 percent or less is best practice)?
Patient registration The revenue cycle starts with patient registration. Patient registration begins with a phone call for an appointment request. Your front-desk staff should interview the patient on the phone to collect billing and insurance information; invite the patient to go online to your website to complete their registration information; and follow up if registration isn't completed two days prior to the appointment — so that the patient's insurance coverage can be verified. You can use an in-office kiosk for patient check in and to collect demographic information. Some kiosks will automatically verify insurance eligibility too. Charge capture Transferring patient charges from the EHR to your practice management (PM) system should be seamless — electronically transmitting data is an example of efficient workflow. But, if you are forcing your providers to first complete a paper visit-encounter form, and then transfer that information to the EHR, it can lead to inconsistencies, lost data, and redundant work processes. Furthermore, asking your check-out station to compare electronic patient information against the paper encounter form is burdensome and creates even more work when discrepancies arise. Automatic payment posting Automatic payment posting can significantly reduce staff work, so why don't more billing staff embrace and drive implementation of auto-post opportunities? Holding tight to the status quo — manual payment posting and reconciliation — is an inefficient use of our most costly resource: staff. Routinely ask your payers, clearinghouses, and software vendors about new services coming online, and roll out every new payer as electronic remittance and auto-posting become available. Investigate a bank lockbox service that converts the paper explanation of benefits (EOBs) to electronic transactions (837s) for automatic posting to patient accounts. Insurance eligibility verification Investigate and incorporate automatic insurance eligibility verification into your work flows. You can use your clearinghouse service to upload the appointment schedule a couple of days in advance, in a batch process. For walk-in patients, use real-time verification through your PM system. An integrated verification solution creates a history within the patient's record that supports follow-up collection efforts, if there are later discrepancies with the payer.
Article by Rosemarie Nelson - See more at: http://www.physicianspractice.com/billing-and-collections/revenue-cycle-management-more-billing-patients?GUID=2E8F906E-CDE7-43B7-AC93-7066F83372C7&rememberme=1&ts=29082013#sthash.Bbvb2ywQ.dpuf
Tuesday, August 27, 2013
Opportunities to Expand and Keep Your Business
By Steven Peltz, from the Jan/Feb issue of HBMA Billing
As a medical practice consultant, one the first areas of a medical practice that I evaluate is the billing department or billing company of a practice that has hired me. In my capacity as the president-elect of the National Society of Certified Healthcare Business Consultants (NSCHBC), I have had informal discussions with HBMA President Don Rodden, CHBME, about the consulting services that billing companies provide to practices, sometimes without understanding how important their role is to the practice.
I was introduced to HBMA by Government Relations Committee Chairman, Barry Reiter, CHBME. He and I have discussed the constant chaos that the healthcare delivery system is in and identified some of the opportunities that arise from that state. You may not know it, but many of you are already consulting, and if you have not set up your engagement contracts wisely, you are missing out both on revenue and having your client understand and appreciate all the value you bring to the practice. As practices merge and are acquired by hospitals, it is a good idea for your company to offer more than one line of service. Here are a few examples of what I do; you may want to consider adding these services to your company if you do not already offer them.
Over the years, I have established a benchmark of what a practice's accounts receivable (A/R) should look like. It is not cast in stone and is not fail proof, but it is a simple measuring tool that I use. I take the A/R temperature of all new clients and put it on a bar graph, then compare it to my benchmarks (see page 24). I then demonstrate to the potential client that by using the graph, their money is worth less the longer it is owed to the practice. I point out that either their billing company or billing department is not meeting the standard. I also break down the front end of the billing process and identify disconnects in the data collection process, such as: poorly trained staff, lack of reconciliation, monitoring, and the final decision with respect to collections.
Reducing the lifetime of debts that your company must collect begins at the point of service. Collecting co-pays at the time of each practice visit reduces postage, cuts billing staff time, and increases cash flow. Increasing the consistency of this front end collection means training the practice's staff to train the patients. For example, the front end staff may say to the patient, "Your co-pay today is $20" and then stop and wait. A more effective script for collecting co-pays may be, "Your co-pay today is $20, and we accept cash, checks, and credit cards. How would you like to pay?" A subtle but important difference, and while it will not work 100% of the time, it will result in increased revenue. Then, tell your client that you will monitor the success of their front office staff in collecting co-pays and refresh the front staff's training a few times a year. Finally, track the front staff collections on a monthly (or less frequent, but consistent) schedule and meet with your client enough times for your client to develop trust in you as a part of the management team.
When patients call to schedule appointments, do the front desk staff members ask for enough information to check insurance eligibility and acquire authorizations, when appropriate, before the visit?
Is there a daily, weekly, or monthly close that reconciles the cash, personal checks, credit card receipts, and insurance checks with the end-of day and end-of-week computer report and the bank statement? This is a simple way to make sure all the funds go into the bank and not into someone's pocket.
Does the office manager or billing department / company supervisor produce a monthly report that compares the charges and collections of the past month with the same month last year and two months before? This will spot and identify trends before they become problems.
During the first few meetings with your client, be prepared to bring something to the discussion that demonstrates the depth and scope of your knowledge and how your expertise will add to the success of the practice. For example, each year Medicare changes their codes; you could explain which, if any, impact the practice. If it is a primary care practice, establish a referral-based report. Identify how many dollars are sent out of the practice and to what specialties. Are there ways to recapture some of those dollars? Is the PCP or the specialist asking enough questions and documenting enough to code one level higher, if appropriate? I usually tell the owners(s) that the practice needs a preventative audit at least once every year and especially after a new provider is hired. When they ask why, I give them examples of other practices that have had to write checks back to payers.
When your client brings in a new provider, do you offer to credential the provider or bring in someone who can? Do you discuss ancillary sources of revenue that other practitioners use that can also be applied to that practice?
You probably already do between 80% and 100% of the above suggestions, but does the client understand how these services impact their practice? The point is whether your client knows that you provide these services. Yes, I know that they do not want to pay more for services that they think should be included, but that is not a reason to forgo informing them of all you do. Enhancing the services that you offer discourages clients from shopping for competing providers – it is much less expensive to keep a client than it is to get a client. Also importantly, by enhancing your services, you become more appealing to potential new clients when you make sales calls and offer to analyze their operational efficiency.
As a consultant, I either know the answer to the question or where to get it. You should be no different. With the constant change in the healthcare delivery system, you need to be constantly enhancing your product and empowering your clients with more opportunities.
Courtesy of: http://www.hbma.org/news/public-news/n_a-reminder-opportunities-to-expand-and-keep-your-business
As a medical practice consultant, one the first areas of a medical practice that I evaluate is the billing department or billing company of a practice that has hired me. In my capacity as the president-elect of the National Society of Certified Healthcare Business Consultants (NSCHBC), I have had informal discussions with HBMA President Don Rodden, CHBME, about the consulting services that billing companies provide to practices, sometimes without understanding how important their role is to the practice.
I was introduced to HBMA by Government Relations Committee Chairman, Barry Reiter, CHBME. He and I have discussed the constant chaos that the healthcare delivery system is in and identified some of the opportunities that arise from that state. You may not know it, but many of you are already consulting, and if you have not set up your engagement contracts wisely, you are missing out both on revenue and having your client understand and appreciate all the value you bring to the practice. As practices merge and are acquired by hospitals, it is a good idea for your company to offer more than one line of service. Here are a few examples of what I do; you may want to consider adding these services to your company if you do not already offer them.
Over the years, I have established a benchmark of what a practice's accounts receivable (A/R) should look like. It is not cast in stone and is not fail proof, but it is a simple measuring tool that I use. I take the A/R temperature of all new clients and put it on a bar graph, then compare it to my benchmarks (see page 24). I then demonstrate to the potential client that by using the graph, their money is worth less the longer it is owed to the practice. I point out that either their billing company or billing department is not meeting the standard. I also break down the front end of the billing process and identify disconnects in the data collection process, such as: poorly trained staff, lack of reconciliation, monitoring, and the final decision with respect to collections.
Reducing the lifetime of debts that your company must collect begins at the point of service. Collecting co-pays at the time of each practice visit reduces postage, cuts billing staff time, and increases cash flow. Increasing the consistency of this front end collection means training the practice's staff to train the patients. For example, the front end staff may say to the patient, "Your co-pay today is $20" and then stop and wait. A more effective script for collecting co-pays may be, "Your co-pay today is $20, and we accept cash, checks, and credit cards. How would you like to pay?" A subtle but important difference, and while it will not work 100% of the time, it will result in increased revenue. Then, tell your client that you will monitor the success of their front office staff in collecting co-pays and refresh the front staff's training a few times a year. Finally, track the front staff collections on a monthly (or less frequent, but consistent) schedule and meet with your client enough times for your client to develop trust in you as a part of the management team.
When patients call to schedule appointments, do the front desk staff members ask for enough information to check insurance eligibility and acquire authorizations, when appropriate, before the visit?
Is there a daily, weekly, or monthly close that reconciles the cash, personal checks, credit card receipts, and insurance checks with the end-of day and end-of-week computer report and the bank statement? This is a simple way to make sure all the funds go into the bank and not into someone's pocket.
Does the office manager or billing department / company supervisor produce a monthly report that compares the charges and collections of the past month with the same month last year and two months before? This will spot and identify trends before they become problems.
During the first few meetings with your client, be prepared to bring something to the discussion that demonstrates the depth and scope of your knowledge and how your expertise will add to the success of the practice. For example, each year Medicare changes their codes; you could explain which, if any, impact the practice. If it is a primary care practice, establish a referral-based report. Identify how many dollars are sent out of the practice and to what specialties. Are there ways to recapture some of those dollars? Is the PCP or the specialist asking enough questions and documenting enough to code one level higher, if appropriate? I usually tell the owners(s) that the practice needs a preventative audit at least once every year and especially after a new provider is hired. When they ask why, I give them examples of other practices that have had to write checks back to payers.
When your client brings in a new provider, do you offer to credential the provider or bring in someone who can? Do you discuss ancillary sources of revenue that other practitioners use that can also be applied to that practice?
You probably already do between 80% and 100% of the above suggestions, but does the client understand how these services impact their practice? The point is whether your client knows that you provide these services. Yes, I know that they do not want to pay more for services that they think should be included, but that is not a reason to forgo informing them of all you do. Enhancing the services that you offer discourages clients from shopping for competing providers – it is much less expensive to keep a client than it is to get a client. Also importantly, by enhancing your services, you become more appealing to potential new clients when you make sales calls and offer to analyze their operational efficiency.
As a consultant, I either know the answer to the question or where to get it. You should be no different. With the constant change in the healthcare delivery system, you need to be constantly enhancing your product and empowering your clients with more opportunities.
Courtesy of: http://www.hbma.org/news/public-news/n_a-reminder-opportunities-to-expand-and-keep-your-business
Four Steps to Healthier Accounts Receivable at Your Medical Practice
It happens in most all practices — the time of the month when cash flow becomes an issue. Instead of panicking and finding short-term solutions for long-standing problems, take a minute to consider the bigger picture.
How would you like your 0-30 days accounts receivable (A/R) to be 80 percent of your total A/R. Yes, it is possible, and the healthiest practices operate with this percent as a long-term goal. Here are some areas you can look at right now that can quickly boost your dwindling cash flow issue:
• Bill your claims out daily. Yes, daily. This will immediately result in your claim being processed within 30 days, and not automatically push it to the 30-60 day category. You're already in trouble if you are not billing out daily. If your billing company or department does not do this now, have a sit-down meeting with them, and ask them to start this process with your claims. You will see immediate results.
• Handle documentation requests from your billing department immediately. This is such a quick and easy solution, that you will see results within a month or two months. When your billing department requests additional documentation either to process an original claim or fulfill a denial or delay in payment from the insurance company, is your staff getting back to them within 24 hours? They should be. Thinking about the lifecycle of a single claim, it's no wonder a majority of you’re A/R is in the 90+ category. If you are billing out on a monthly basis, your claims are already in the 30-60 day category. On top of that, you now have to wait to hear back from the insurance company, so your claims are now in the 45-60 day category. If your billing department has requested documentation, and your staff is sitting on those requests because they're too busy processing patients, now you've pushed the claim out to the 75-90 day category. See how quickly this can happen? Filling your lobby and rooms with more patients is not the long-term solution.
• Follow up with your billing department. Whether it is an internal billing department or an outsourced company, following up with them in critical. Some companies don't want to bother with secondary claims because the yield is low. Denials are also more work and require more time with sometimes poor results. Following up with them as frequently as possible — a minimum once a month — is a critical step in lowering you’re a/R.
• Are all of your practitioners on your insurance contracts? Many plans have applications the physician, nurse practitioner, or physician assistant must fill out that include their license number and NPI. If your staff have not filled these out, then you need to check to see if your adjustments (write-offs) are due to a physician not being on a particular contract. Blue Cross, Blue Shield, United Health Care, TriCare, and Medicare, are just a few that require this certification. Some workers' compensation companies pay differently (up to $10/ visit to $15/visit) for therapists who are considered in-network versus out-of-network. It's really worth your time to ask.
By following these four tips today, you can shorten the time between seeing a patient and being paid for your services. They are easy, quick and will yield you the highest result in the shortest amount of time.
Article By P.j. Cloud-moulds http://www.physicianspractice.com/medical-billing-collections/four-steps-healthier-accounts-receivable-your-medical-practice
How would you like your 0-30 days accounts receivable (A/R) to be 80 percent of your total A/R. Yes, it is possible, and the healthiest practices operate with this percent as a long-term goal. Here are some areas you can look at right now that can quickly boost your dwindling cash flow issue:
• Bill your claims out daily. Yes, daily. This will immediately result in your claim being processed within 30 days, and not automatically push it to the 30-60 day category. You're already in trouble if you are not billing out daily. If your billing company or department does not do this now, have a sit-down meeting with them, and ask them to start this process with your claims. You will see immediate results.
• Handle documentation requests from your billing department immediately. This is such a quick and easy solution, that you will see results within a month or two months. When your billing department requests additional documentation either to process an original claim or fulfill a denial or delay in payment from the insurance company, is your staff getting back to them within 24 hours? They should be. Thinking about the lifecycle of a single claim, it's no wonder a majority of you’re A/R is in the 90+ category. If you are billing out on a monthly basis, your claims are already in the 30-60 day category. On top of that, you now have to wait to hear back from the insurance company, so your claims are now in the 45-60 day category. If your billing department has requested documentation, and your staff is sitting on those requests because they're too busy processing patients, now you've pushed the claim out to the 75-90 day category. See how quickly this can happen? Filling your lobby and rooms with more patients is not the long-term solution.
• Follow up with your billing department. Whether it is an internal billing department or an outsourced company, following up with them in critical. Some companies don't want to bother with secondary claims because the yield is low. Denials are also more work and require more time with sometimes poor results. Following up with them as frequently as possible — a minimum once a month — is a critical step in lowering you’re a/R.
• Are all of your practitioners on your insurance contracts? Many plans have applications the physician, nurse practitioner, or physician assistant must fill out that include their license number and NPI. If your staff have not filled these out, then you need to check to see if your adjustments (write-offs) are due to a physician not being on a particular contract. Blue Cross, Blue Shield, United Health Care, TriCare, and Medicare, are just a few that require this certification. Some workers' compensation companies pay differently (up to $10/ visit to $15/visit) for therapists who are considered in-network versus out-of-network. It's really worth your time to ask.
By following these four tips today, you can shorten the time between seeing a patient and being paid for your services. They are easy, quick and will yield you the highest result in the shortest amount of time.
Article By P.j. Cloud-moulds http://www.physicianspractice.com/medical-billing-collections/four-steps-healthier-accounts-receivable-your-medical-practice
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