Maximizing collections is just one component of effective revenue cycle management. But if practices overlook this key step, they risk forfeiting money they’re owed and losing out on much-needed revenue.
Read on to find out how you can improve collections and cash flow today.
Medical billing challenges amid the pandemic
Despite resuming in-person visits and elective surgeries, many practices still struggle with reduced patient volume and the resulting decrease in practice revenue.
From mid-February to early April 2020, patient volume at ambulatory practices dropped almost 60%, a COVID-19 impact study by researchers at Harvard University and Greenway Marketplace Partner Phreesia found. Following its first publication on April 23, the study was later expanded through May 16 and showed an increase in the number of patient visits. However, the total number was still down about 31% from pre-pandemic levels.
While all specialties are experiencing rebounds in patient volume, the study noted that surgical specialties and pediatric practices had the largest relative decline in visits.
Patient hesitation to visit practices is one contributor to lower patient volume. A recent poll found that 29% of adults were delaying medical care due to COVID-19 fears.
If your practice revenue continues to suffer from the pandemic, improving your patient collections process could help you maintain cash flow.
Tips for effective patient balance collections
- Collect patient insurance and contact information before appointments.
When a patient calls your office to make an appointment, front desk staff should collect current, complete information or give patients the option to mail or email it instead. Your patient portal or online appointment tool should also have fields to collect or update this information.
Ensuring accurate insurance and contact information will allow staff to verify coverage and follow up with the patient throughout the treatment and patient collections processes.
- Verify insurance eligibility and identify any outstanding balances.
Before or at the time of service, verify coverage with payers and clarify payer rules. Taking these steps will help to pinpoint any patient collections changes that may have occurred, what portion of charges for the expected treatment will be covered, and patient responsibility for payment.
- Implement a payment policy that requires patient responsibility at check-in.
The best way to collect patient balances is to require patients to cover copays and patient responsibility at check-in.
To ensure patients are aware of this requirement, create a medical office payment policy. Then, include a patient responsibility agreement in your check-in paperwork for patients to sign. The purpose of this policy is to provide patients — and your staff — clear guidelines for collections.
Additionally, use your patient messaging solution to send automated appointment reminders communicating what’s due at the time of service.
- Accept multiple payment methods.
Increase the likelihood of collecting balances at check-in by offering a variety of payment methods, including cash, credit/debit card, or check. Having a convenient and easy-to-use online payment tool in your patient portal can also facilitate patient payments.
- Offer payment plans — and track them.
For larger balances, establish payment plans and train staff on how to explain these options and track them properly. Offering a more flexible payment option will help your practice increase collections and give patients peace of mind knowing they can pay for the treatments they need.
- Make follow-up part of the collections process.
Perseverance is key to maximizing collections. Develop a proactive plan for contacting patients who don’t make timely payments and create a script for staff to follow. Your staff should be prepared to request payment in full, discuss payment options, and offer a payment plan if needed.
How could a medical billing and collections service help?
Value-based care programs, changing payer fee schedules, employee attrition, government regulations, lack of training and resources, and high-deductible health plans may be factors causing your practice to bring in less revenue than it’s truly earning.
Staying financially healthy in a challenging regulatory environment is no easy task. It requires knowing how to get paid for your services — from handling claim denials and improving denial management and underpayments to following up on outstanding payments.
In addition to the patient collection tips above, practices also need to maintain up-to-date payer fee schedules, file secondary insurance claims, and ensure correct coding to avoid undercharging.
To increase profitability, many practices partner with revenue cycle management experts. To evaluate your current billing staff or health IT vendor, view this infographic for questions to ask.
Here are a few ways a medical billing service can help you collect every dollar you’re owed:
Accurate payment posting
Payment posting is an important step in the medical billing process because errors in posted payments can detract from the accuracy of accounts receivable (A/R) reports and foster mistrust in patients who receive erroneous statements. Relying on a medical billing partner to post payments can give your practice peace of mind that any potential issues will be caught and resolved.
Tracking and lowering days in A/R
Days in A/R is the time an invoice is outstanding before it’s collected. It’s an important metric to track because if you don’t collect payments, you reduce your margins and may find yourself writing off more and more patient A/R.
You can calculate your days in A/R by determining average daily charges for the length of time you want to measure. To determine your average daily charges, add the posted charges for your chosen time period, subtract credits received, and divide by the number of days in that period. Then, divide your total accounts receivable by the average daily charges.
Practices should aim for 30 to 40 days in A/R. Partnering with a medical billing service can help you monitor and improve this KPI.
Reworking MEDICAL claims
As soon as a claim is denied or partially paid, a medical billing service can tag it with a denial/follow-up reason code, make needed corrections to the claim, and resubmit a “corrected claim” based on payer guidelines.
A revenue cycle partner can assist in your healthcare claims management by working to eliminate the claim rejections and denials that prevent reimbursements.
It can help you avoid these common rejection reasons:
- Duplicate claims
- Eligibility
- Payer ID missing or invalid
- Billing provider national provider identifier (NPI) missing or invalid
- Invalid diagnosis codes
After identifying the source of the issue, your billing partner can work with you to develop best practices to help you face fewer denials and can apply specialty-specific knowledge to increase your clean claims rate.
Decreased turnaround time on claim submissions
By ensuring claims are submitted correctly on the front end, a medical billing service can help your practice receive faster reimbursement. After charges are entered, it can work any clearinghouse rejections and submit claims.
Offering best practices training and monthly reports
Through training sessions, your medical billing partner may share its knowledge on topics such as eligibility and referral management functionality or patient payment posting. It may also send you monthly reports to keep you up to date on your practice’s KPIs.
Greenway Revenue Services offers an end-of-month (EOM) package that provides a monthly report with an A/R recap, including:
- Current days in accounts receivable (A/R)
- Clean claims rate
- Aging percentages
- Visit count by billable provider
- Clearinghouse rejection count
- Provider revenue summary
- Service analysis report
Improving your cash flow starts with a partnership
Take your first step toward greater financial stability by enlisting the help of a medical billing service. With expert staff knowledgeable in specialty-specific billing, Greenway Revenue Services can help you boost practice revenue and achieve your financial goals.
Your dedicated team will manage back office and billing functions, rework denials and rejections daily, ensure claims are submitted correctly, send patient statements and collection letters, and more.
For rapid revenue relief, we offer GRS Express, a simplified solution that focuses on essential billing services to protect your cash flow. To learn more about GRS Express, view details here.
For more information, CLICK HERE to schedule a conversation with a Greenway representative. Or watch our 3-minute overview video HERE.
