Talk to doctors or other practitioners and you will hear it over and over again: one of the biggest challenges of maintaining a functional medical office is to collect all the money that is due to the practice. Payer denial will be more pronounced with evolving reimbursement models, ongoing payment coverage changes and significant coding updates. Add to the mix that greater financial obligation is borne by the majority of patients due to high deductible plans, non-insurance or underinsurance. More medical practice is implementing front end collection rules to better deal with some of these barriers.
Credit card authorization on file
When medical consultants look at what is actually happening in practice, one of the major conclusions is that in many cases, the medical office simply does not have a solid and secure way to store a patient’s credit card information in the delayed billing archive. This means deductibles, co-pays and other amounts of money go out the door with the patient. Experts point out how paper-based credit card systems have exposed suppliers to liability in the past. However, with new forms of cloud-hosted provider systems, sometimes medical practices are able to store credit card information securely to automatically bill a card when the insurer’s response is received.
To streamline this process, you need to incorporate a credit card into the file authorization of your financial policy. Write down the exact terms, limits and expirations that the permit will cover. Eg. The patient’s credit card is charged for an outstanding balance of $ 50.00 or less, and no prior authorization notice is required by practice. As with most everything in healthcare, the more transparency you can offer, the better procurement and collaboration you get from your patients.
Pre-registration and verification of insurance
Another very important element is to verify insurance before a visit. There is a core process for ensuring that a patient has insurance, and then there are the other details of follow-up to ensure that insurance is effective or will be effective at the date of service and whether a particular procedure or visit is covered by the terms of the insurance contract. Many doctors already use hosts of people to review these complicated details, but many practices could benefit from more staff hours spent on handling billing issues and revenue cycles.
By knowing if your patient has coverage prior to the appointment, you can better facilitate a conversation about his / her treatment plan course of action and financial responsibility. Some practices install kiosks with easy-to-use step-by-step screens to collect insurance and demographic information, others offer a secure patient portal that allows patients to fill in their details online or downloadable forms from the practice website. These options not only help manage critical details but also speed up the registration process.
When walking around patients or last-minute appointments, practitioners can easily seek benefits on a payer’s direct site or through a clearinghouse location. Some practice management systems have this feature built in for convenience. Payers must respond within 20 seconds of a real-time request.
Another key that has helped some offices is simply to make a financial quality assurance review of the medical billing processes. This basically means getting an external set of eyes to look at how well internal office staff handle processes such as registration and insurance certification, as well as the issuance of claims to public or private insurers. This oversight can tighten up a revenue cycle and help a practice ensure it gets the money it deserves for services offered, giving clinical professionals the peace of mind of their long-term financial solvency.