Estimating Payments Upfront Based on Eligibility Significantly Improves Collection MarginsA proficient medical billing collection process can drastically reduce time between services offered and payment. Conversely, though, inefficiencies in the collection process can increase overhead as the front desk attempts to chase down delayed payments, retroactively encourage customers to cover the cost of rejected claims, or process reimbursements to patients as a result of over collecting. All told, medical billing complexities account for several hundred billion dollars worth of lost revenue to U.S. health care providers each year, according to BMC Health Services Research study.

As daunting as that figure may seem, however, there are several operational best practices that can significantly improve medical billing collection rates. Here are the top three:

1. Estimate Payments Prior to Rendering Services

Two of the most common sources of collection hiccups are under- and over-collecting at the time of the appointment. The former is problematic for the obvious reason that not collecting the correct, full amount at the time of service reduces the chances of patients paying their portion of the bill by 40 percent, according to Becker's ASC Review. On the other hand, over-collecting will result in more administrative processes, and as independent practices are all too aware, time is money. In fact, practices may collectively spend as much as $70 million on bureaucratic tasks related to billing and insurance in a given year. The less leg-work required of the front desk to get payments processed quickly, the better.

The most effective way to prevent these problems is to use a data-driven payment estimation process prior to the visit. A practice management system that links up with health insurance companies' data services can quickly process each patient's eligibility. Such a system can help project the costs upfront, based on the reason for the visit, but also in accordance with eligibility and benefits. Collections (e.g. co-payments and upfront costs) are subsequently more accurate at the time of the visit, and the likelihood that patients will be met with higher-out-of-pocket costs than expected is curbed.

At the time services are rendered, precise coding, including specific modifiers, can be factored into the final expense in real time. Live calculations are made to determine coverage and deductible standing so that there's greater transparency into the final cost of services for the patient. Likewise, this reduces the chances of lost revenue from accidental downcoding. The result: Accurate payments are more likely to be made at the time of the visit.

2. Provide Multiple Payment Mechanisms

As deductibles rise, independent practices must do everything they can to make it as easy as possible for patients to quickly pay for services rendered. Collections don't just need to be accurate; they also need to be convenient.

According to Healthcare Dive, one of the best ways to encourage on-time payments is to use online patient portals that enable credit card and even PayPal payments. In a way, this is just common sense. Many businesses offer customers multi-channel purchasing methods for the majority of services and products. Why should there be a disconnect in health care, an industry that is perhaps in the most dire need of a simpler payment collections process? Enabling an online payment portal is also a great way to quickly notify patients of outstanding payments and to encourage them to pay off their balance without having to physically return to the office or send payment data via mail. Again, the ideal option is to collect payments while the patient is onsite, but an online payment portal is a strong plan B.

An online patient portal also offers a great opportunity for patients to provide key information including insurance data, prior medical history, reason for visit and other details that are needed prior to an appointment to optimize care and cost estimations. Many patients may prefer this method of appointment scheduling. Others may prefer to have their questions about insurance and billing answered over online chat or email as opposed to having to wait on hold.

3. Keep Payment Data on File

Last but not least, the same practice management solution you use to estimate payment amounts and facilitate online patient interactions should also give you the option to save payment information, such as credit cards, on file.

If, for whatever reason, you are unable to process a payment at the time the service is rendered, you can create a payment program that charges the customer's debit or credit card. This type of payment feature simultaneously increases medical billing collection rates and gives customers one less thing to have to follow up on.

AllMeds RCM for Your PracticeTo learn more about how a strong practice management solution can facilitate smooth revenue cycle management and improve collection margins, click here.

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Estimating Payments Upfront Based on Eligibility Significantly Improves Collection Margins

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Estimating Payments Upfront Based on Eligibility Significantly Improves Collection Margins

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AllMeds EHR PM RCM

Estimating Payments Upfront Based on Eligibility Significantly Improves Collection Margins

AllMeds RCM for Your Practice

AllMeds Specialty Practice Services

Estimating Payments Upfront Based on Eligibility Significantly Improves Collection Margins

AllMeds RCM for Your Practice

AllMeds Specialty Practice Services