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Revenue Cycle Management (RCM)

Effective RCM Strategies to Collect Maximum Patient Responsibility

Patients’ financial responsibility is on the rise as more patients are choosing high-deductible health plans (HDHP). Increasing patient responsibility is an ongoing trend that does not seem to be slowing down in the near future. Providers report many challenges with responding to growing patient financial responsibility. Given the increased payment responsibility, being able to determine and collect a patients’ ability to pay is increasingly important for any practice. In order to allow patients to focus on getting the care they need; healthcare providers need effective RCM strategies to help patients meet their financial obligations and to establish funding mechanisms that will benefit both the patient and the provider. In this article, we shared three effective RCM strategies that will help to collect maximum patient responsibility. 

Effective RCM Strategies to Collect Maximum Patient Responsibility

  1. Communicate Practice’s Financial Policy

A clear and reasonable financial policy is the first step in setting expectations with patients about their financial responsibility. Some practices share copies of their financial policy as part of a welcome packet and when the patient checks into the office for the first time, they have patients sign that they read and understand it. Patients who indicate they need further clarification are invited to come into the office and discuss the policy with the practice manager privately. In general, the policy explains what patients are expected to bring to every visit, such as their insurance card and identification; their responsibility to contact their health plan about specific coverage questions; and that payment is due at the time of service unless alternate arrangements, such as a payment plan, have been made. Some practices also offer a prompt payment discount for patients who choose not to use health insurance. The discounted fee cannot go below the Medicare allowable and is due at the time of service. In addition to having patients sign off on financial policies and posting them on the practice website, practices should consider placing hard copies of the policy in their reception area. Particularly at the beginning of the year, when deductibles reset, it’s a good idea to make this information available for patients to review while they’re waiting to see the provider.

  1. Keep Credit Card Information

Keeping credit card information in the patient’s accounts is a logical solution considering more high-deductible health plans. But you should clearly communicate about keeping credit cards on file in your financial policy. The practice will send out claims to patients’ insurance carriers and will bill patients for their portion of the balance, per the insurance carrier’s explanation of benefits. In such scenarios, if you are unable to collect in full for our services after several attempts to collect, you reserve the right to process the patient’s credit card. Obviously, your staff should be prepared with an explanation of benefits for all such transactions. Beyond that, you must ensure that your practice is equipped with adequate cybersecurity to protect patients’ financial information and that your policy complies with state laws and regulations. Make sure that access to credit card information is very limited internally, and totally impossible externally. And notify the patient in advance of every draft being taken out or payment being made. As insurance plans frequently change and credit cards expire, we recommend updating patient insurance and credit card information at least annually.

  1. Have Well Trained Staff

Your staff inevitably will encounter patients who are not aware of various insurance terminology, such as deductibles, coinsurance, and co-payments, and how that translates to their out-of-pocket expense. If you want to collect the money that’s owed to you, you have to be willing to invest some time in making sure staff are trained to help, as a way of showing patients you want to help them beyond medical services. Your billing team should be well-versed in understanding the ins and outs of insurance policies in general and common issues that can arise with payers so that they can serve as a source of expertise for staff at the front desk. Ideally, the front desk staff is trained to field these frequent questions or common scenarios. For example, most health plans will cover one physical per calendar year. If patients want to have it early, perhaps due to travel or another reason, staff should call the insurance company and ask whether the visit will be covered. For staff to attain this competency, solid training is crucial. 

Above mentioned RCM strategies will help you to collect the maximum portion of patient responsibility. If you help you inaccurate billing and collecting patient responsibilities, MedicalBillersandCoders (MBC) can assist you. Our eligibility and benefits verification services ensure you will have an insurance coverage report well in advance before your visit. To know more about our overall medical billing and coding services, contact us at 888-357-3226


Medical Billers and Coders

Catering to more than 40 specialties, Medical Billers and Coders (MBC) is proficient in handling services that range from revenue cycle management to ICD-10 testing solutions. The main goal of our organization is to assist physicians looking for billers and coders, at the same time help billing specialists looking for jobs, reach the right place.

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