Patient healthcare costs rise again lessen burdens increase revenue

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“Patient Healthcare Costs Rise Again, Clinicspectrum’s Solutions Lessen the Burdens and Increase Revenue”

According to a recent article dated November 13th, 2014 on Forbes.com, “Worker Out-Of-Pocket Health Costs Have Doubled In Five Years”, the healthcare landscape is predicted to change even further in 2015.  “As the economy improves and employees spend more on health care, employer-paid premiums are rising again with an increase of 5.5 percent forecast for 2015 with worker premiums and out-of-pocket costs – which have doubled since 2009 – rising at an even faster clip.”  Additionally, the annual healthcare costs per employee have risen from $10,717 to $11,304 this year.  This means that more out of pocket expenses are outstanding and collecting that money can raise new challenges for medical groups.  Strategic solutions must be implemented in the areas of proper benefit verification, and automated patient collections to reduce revenue downfalls for practices.

 

In fact, practices are generating up to 30 to 40 percent of their revenue from patients who have high-deductible insurance coverage. Failing to check patient eligibility and deductibles can increase denials, negatively impact cash flow and profitability.

One solution is to improve eligibility checking using the following best practices:

-Check patient eligibility 48 to 72 hours in advance of scheduled visit using one of these three methods:

  1. Business-to-business (B2B) verification, which enables practices to electronically check patient eligibility using electronic data interchange (EDI) via their electronic health record (EHR) and practice management solutions.
  2. Look up patient eligibility on payer websites.
  3. Call payers to determine eligibility for more complex scenarios, such as coverage of particular procedures and services, determining calendar year maximum coverage, or if services are covered if they take place in an office or diagnostic center. Clearinghouses do not provide these details, so calling the payer is necessary for these scenarios.

-Determine patient financial responsibilities – high deductibles, out-of-pocket limits, then counsel patients about their financial responsibilities before service delivery, educating them on how much they’ll need to pay and when.

-Determine co-pays and collect before service delivery.

Another area of potential pitfall for revenue optimization comes from collecting patient balances after the services have been rendered.  It is imperative for medical groups to turn to automated solutions to help recover those balances seamlessly and effectively.

Automated collection software can be installed and managed by practices to relentlessly – within regulations – contact debtors to increase collection rates. Traditional collection methods of standard mail delivery and costly representative phone calls are replaced by a more elaborate, seamless, cost-effective auto collection process.  Automated collection methods using technology platforms, decisions rules and messaging such as text, email, push notifications on smart phones and automated calls to allow seamless, consistent results for balance collection.

For more information on ways we can help, visit our website, www.clinicspectrum.com.

 

Quit ‘Leaving Money on the Table’ with Automated Collection Software

At what point should practices “leave money on the table” and abandon their collection efforts on patient-owed balances? It’s a difficult decision that today’s practices are being forced to make more often than they’d like.

Automated Collection SoftwareCollecting past-due balances from patients is an important component of the revenue cycle that physician practices must actively manage, but it’s costly, time-consuming and labor-intensive. Only a relatively small percentage of efforts result in successful collection. For the remaining patients who fail to respond, practices are forced to report debts to credit bureaus or take legal action to collect past-due balances. In the end, every dollar invested in the collection process is one less dollar of profit for the practice.

But it gets worse. The cost of collecting on small-dollar accounts can easily exceed the past-due balance. The result is that many practices choose to “leave money on the table” rather than pursue advanced collection efforts. Over the course of year, these ignored accounts add up to a substantial sum of money.

Perhaps now, with the assistance of technology, practices will no longer have to make the decision to forego collecting past-due balances. A new breed of automated collection software eases the burden of patient collections. These solutions reduce the time and costs associated with standard mail delivery and costly representative phone calls.

Automated collection software can be installed and managed by practices to relentlessly – within regulations – contact debtors to increase collection rates. Practices that are considering the implementation of this software should look for the following capabilities:

  • Messaging Options – These allow practices to tailor how the patient will be contacted. Options include text, secure text, email, secure email, push notifications to smart phones, and automated calls. These options allow practice to contact debtors via multiple methods to increase collections.
  • Decision Rules – These allow practices to configure when and how often the debtor is contacted. Options include setting the date, time, hour and frequency of contact.

Practices employing automated collection software can reduce their collection costs and increase the chances of collecting balances by eliminating representative involvement and automating the process. Most importantly, practices can quit “leaving money on the table.”

Automate to Collect patient balances

Out of sight, out of mind. Applied to healthcare, this age-old saying is not only true, but also incredibly problematic for physician practices. All too frequently we hear from physicians the same story of providing care up-front, and subsequently facing a growing stack of un-paid deductibles, ultimately hurting the bottom line. No one is immune to this – not general practitioners, specialists, psychologists, nor dentists.

With the trend of increasing deductibles, there is only going to be more to collect. For 2014, the internal revenue service has defined high-deductible as $1250 for an individual and $2500 for a family. On top of that, maximum out-of-pocket expenditures are estimated at $6350 for individuals and $12,700 for families. That’s no small change; that’s real money when factoring in the number of patients you see.

Some practices may have an initial reaction of fear or a sense of alarm from these numbers however, these statistics should be the impetus to be proactive and put the right series of steps and technologies into place. Those steps include implementing a hybrid workflow model that starts with using an established eligibility checking system to identify a patient’s expected out-of-pocket costs prior to an appointment will significantly lessen the follow-up collections that are needed. However, when you do need to collect, make sure you are doing it smartly by leveraging the second piece of a hybrid workflow solution, an automated collection system to significantly increase the odds that you will collect more, and also collect it faster.

Recent highlights from the Pew Research Internet Project state that as of January 2014, 58% of adult Americans have a smartphone.  Doesn’t it make sense then that you should have an automated system that includes texting alerts instead of sending outdated hard copy letters? By replacing traditional collection methods with an automated technology platform that smartly uses decision rules to push out text and secure e-mail, and logs a record of all the activity, you can count your profits instead of counting the number of uncollected deductibles.

Automate to Collect

Laptop doctorOut of sight, out of mind. Applied to healthcare, this age-old saying is not only true, but also incredibly problematic for physician practices. All too frequently we hear from physicians the same story of providing care up-front, and subsequently facing a growing stack of un-paid deductibles, ultimately hurting the bottom line. No one is immune to this – not general practitioners, specialists, psychologists, nor dentists.

With the trend of increasing deductibles, there is only going to be more to collect. For 2014, the internal revenue service has defined high-deductible as $1250 for an individual and $2500 for a family. On top of that, maximum out-of-pocket expenditures are estimated at $6350 for individuals and $12,700 for families. That’s no small change; that’s real money when factoring in the number of patients you see.

Some practices may have an initial reaction of fear or a sense of alarm from these numbers however, these statistics should be the impetus to be proactive and put the right series of steps and technologies into place. Those steps include implementing a hybrid workflow model that starts with using an established eligibility checking system to identify a patient’s expected out-of-pocket costs prior to an appointment will significantly lessen the follow-up collections that are needed. However, when you do need to collect, make sure you are doing it smartly by leveraging the second piece of a hybrid workflow solution, an automated collection system to significantly increase the odds that you will collect more, and also collect it faster.

Recent highlights from the Pew Research Internet Project state that as of January 2014, 58% of adult Americans have a smartphone.  Doesn’t it make sense then that you should have an automated system that includes texting alerts instead of sending outdated hard copy letters? By replacing traditional collection methods with an automated technology platform that smartly uses decision rules to push out text and secure e-mail, and logs a record of all the activity, you can count your profits instead of counting the number of uncollected deductibles.

A Complete Guide of our Technically Sound Product : CredentialingSpectrum

A complete credentialing profile module for:

  • Management of Credentialing and Re-credentialing activities and reminders
  • Complete Cloud based Documents Management for Credentialing Documents
  • Reminders on Expiration of various credentials such as CDS, DEA, License, CAQH, Board Certification, Mal Practice , Hospital Privileges
  • Facility Credentialing Management
  • Insurance Participation Agreements and/or Contract Management
  • Auto-fax, Auto-email and Secure Messaging Capability
  • Extensive Report and/or analytics Module