1. Minimize the need for collections by asking patients for their payments upfront.Create a checklist for your staff to follow with regard to procedures for copying insurance cards, verifying patients’ data, collecting payments, and confirming contact information. Your staff members may know the basics, but are they consistently performing them? Consistency is key. Alternatively, make the necessary arrangements for patients to be able to pay later. Focus on the start of the physician/patient encounter because that is the time when it is easiest to collect out-of-pocket payments.
Because of the availability of high-deductible plans, patients have become responsible for paying more of their bills than ever before. Unfortunately, it is more difficult to collect from patients than from governmental or private insurance companies. Therefore, it is imperative that you maximize your ability to collect out-of-pocket expenses. By collecting payment before services are rendered, you may be able to forego billing, collections, and possibly even bad debt write-offs.
2. Educate your employees so that they can, in turn, educate patients about their financial obligations at the beginning of the process of receiving medical care. If you can financially clear patients by communicating costs in a transparent manner, you can help your healthcare organization avoid the need for debt collection. Patients are more apt to pay in full when they know what to expect. Medical bills go unpaid when patients do not completely understand their statements or when they find that they owe more than they had anticipated.
Train your staff to be ready to provide estimates of the costs of medical services. Develop scripts to guide staff members so that they can be prepared to confidently have conversations with patients about out-of-pocket expenses. Staff should also be able to inform patients about the availability of financial assistance programs and whether they are eligible. Make it convenient and pleasant for patients to cooperate with your staff, and they will be more likely to provide you with their correct insurance and registration details. Communicate these policies with both front and back office staff.
3. Provide different alternatives to make it easier and more convenient for patients to pay. You can offer options to pay via electronic bank payments, health savings accounts, credit cards, cash, checks, in-person, or by phone. Go high-tech by offering patients an online option for paying through a well-designed, branded portal. Via the portal, patients may be able to keep track of their appointments, pay bills, and monitor their health records and results. Portals may also feature payment plans and financing options, as well as facilitate confidential communications between patients and healthcare providers.
If possible, try to initiate contact with your patients before they are admitted. Call them before they come in for their appointments to discuss what the amount of their co-pay will be. Clarify how to deliver payments. Perhaps you can receive payment in advance over the phone. All of these efforts can dramatically bolster revenue. Increased pre-admission contact prevents confusing encounters about information updates and insurances changes that frequently tie up registration desks. If you can provide patients with the answers to their administrative questions before their appointments, you can increase their satisfaction with your services and, subsequently, their loyalty to you as a medical provider.
4. Use data analytics to create an action plan and apply evidence-based strategies for improving revenue cycle management. Exercise patience and take a long-term view by setting realistic goals that slowly improving your performance over time. You cannot manage what you are not measuring, so start measuring key performance indicators (KPI). Consider the following questions:
- Of the myriad KPIs out there, which are important ones for your practice?
- What are the current values for those KPIs in your office?
- How do the KPI values of your organization measure up against the benchmarks of the industry?
- What trends have you observing about your revenue cycles over time?
- Are there inefficiencies or costly errors being made in billing and coding that are creating a loss of revenue?
- Track denied claims to identify trending errors.
- What steps can you take to correct them?
- When you can look back and see the common reasons for denials or payments, you can use that information to predict future outcomes.
BONUS: Do not wait to revisit your daily processes until you are surprised by something. Look for ways to streamline activities related to registration, payment collection, and claims processing. Preventative measures can keep operations running smoothly. Consistently maintain tech processes in order to decrease downtime.
Keep a clear channel open for communicating with payers. Monitor your contracts to determine if payers are reimbursing you for less than they should, denying too many claims, or making unreasonable demands. Consider filling gaps in your revenue cycle by obtaining new technology or employing service vendors to provide the support that you need.