Why does your Staff Fail to Collect Revenue from Patients?


Why does your Staff Fail to Collect Revenue from Patients?As per Consumer Financial Protection Bureau (CFPB) report released in December 2014, 43 million citizens have overdue medical debt and a staggering 52 % of all debt on credit reports is from medical billing. The findings of the study clearly indicate that patient  collection is becoming a  serious  threat to the profitability of provider’s office. Factors like ongoing economic instability combined with implementation of Affordable Health Care Act and shift in payment models to be consumer-direct with high deductibles, have all consolidated into greater difficulties for the provider’s office at revenue collection from patients. To elaborate, here are a few reasons why provider’s offices fail, and steps the office can take to increase collections from patients: -

1. Vague financial policy and procedures – Medical billing and revenue cycle can be complex and confusing concepts. Lack of crystal clear written policies and procedures at the disposal of provider’s staff only aggravates the problem. Ideally speaking, the policies should clearly outline what the payers consider acceptable and information in terms of patient payment timing and extended payment plans. The staff should be educated about the difference in payment responsibilities when the patient is not insured, out of network and alternatively covered by a contracted plan; something the staff of medical revenue billing services is well-versed with.

2. Sharp rise in volume of patients – Approximately, 40% of adults, who were earlier not covered by payers due to factors like age, gender, health history etc., will now obtain coverage, thanks to the new Affordable Health Care Act which requires insurance companies to cover such cases regardless of pre-existing conditions. As a result, a substantial rise in health insurance enrollments is impending. Quantum could become an issue and if that happens, quality would be at an obvious risk. The new rules also provide for increased expenses and thus more confusions. The trend is bound to result in more medical billing errors and the necessity to re-submit claims. Indeed, the provider’s staff is bound to find itself at the end of its wits if not trained to be well-acquainted with new procedures.

3. Lack of advanced tools and technology – Latest information technology allows provider’s office to generate an accurate online estimate of the patient’s portion of the bill in real-time. Not to mention, timely verification of insurance coverage substantially reduces possibilities of claim denials or missing copays/deductibles. Since, upgrading to state-of-the-art technology can be a substantial investment, the provider’s office can leverage from outsourcing its end-to-end revenue cycle management to revenue billing services that are equipped with trained staff and latest online systems.

4. Inadequate staff training and monitoring – Many staff members are uncomfortable requesting co-pays and outstanding balances from patients. With the well-trained staff, you can collect patient payments at the time of the visit. As per Hawthorne effect, monitoring  staff also increases their performance. Indicators to help monitor may include upfront collection percentage, gross collection percentage, total accounts receivable and days in accounts receivable. Indeed, monitoring staff would translate into an additional administrative burden for the provider’s office.

Medicalbillersandcoders.com is well versed with the massive medical billing changes due to the Affordable Health Care Act. The revenue billing service not only has revenue cycle management expertise, but also qualified and trained personnel for ensuring improved cash flow and maximized revenue for medical practitioners.

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