Talk with doctors or other practice leaders, and you’ll hear it again and again: one of the top challenges in maintaining a functional medical office is in collecting all the money that is due to the practice. Payer denials will become more pronounced with evolving reimbursement models, continuous payer coverage changes, and significant coding updates. Add in the mix that greater financial obligation is borne by the majority of patients because of high deductible plans, non-insurance, or underinsurance. More medical practices are implementing front end collection rules to better manage some of these obstacles.
Credit Card Authorization on File
When medical consultants look at what’s actually happening at practices, one of the big findings is that in many cases, the doctor’s office simply doesn’t have a solid and secure way of keeping a patient’s credit card information on file for delayed billing. That means that deductibles, co-pays and other amounts of money are walking out the door along with the patient. Experts point out how paper-based credit card systems have exposed providers to liability in the past. However, with new kinds of cloud hosted vendor systems, medical practices are sometimes able to keep credit card information securely to automatically bill a card after insurer responses are received.
To streamline this process, incorporate a credit card on file authorization in your financial policy. Spell out the exact terms, limits, and expiration that the authorization will cover. For instance, the patient’s credit card will be charged for an outstanding balance of $ 50.00 or less and no prior re-authorization notification is required by the practice. As with most everything in healthcare, the more transparency you can offer, the better buy in and cooperation you’ll receive 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 of making sure that a patient has insurance, and then there are the other details of following up in making sure the insurance is effective, or will be effective on the date of service, and whether a certain procedure or visit is covered under the terms of the insurance contract. Many doctors already use hosts of people to go through these complicated details, but many practices could benefit from more staff hours put towards handling billing questions and revenue collection cycles.
By knowing if your patient has coverage before the appointment, you can better facilitate a conversation on his/her treatment plan course of action and financial responsibility. Some practices are installing kiosks with user-friendly step by step screens to capture insurance and demographic information, others offer a secure patient portal that patients access to complete their details online or downloadable forms from the practice website. Not only do these options assist with managing critical details but also speed the registration process.
For walk in patients or last-minute appointments, practice staff can easily look up benefits on a payer’s direct website or through a clearinghouse site. Some practice management systems have this feature built-in for convenience. Payers are required to give a response within 20 seconds of a real-time request.
Another key that has helped some offices is to simply conduct a financial quality assurance audit on the processes around medical billing. This basically means getting an outside set of eyes to look at how well internal clerical workers are handling processes like registration and insurance certification as well as sending out claims to government or private insurers. This oversight can tighten up a revenue cycle and help a practice make sure that it is getting the money that it deserves for services offered, giving clinical professionals peace of mind about their financial solvency in the long-term.