For physicians and other healthcare providers, the healthcare revenue cycle management
For physicians and other healthcare providers, the healthcare revenue cycle management (RCM) function for patients can be an administrative nightmare. To help your practice do a better job of collecting on patient accounts, you must place a priority on educating patients and helping them understand the insurer’s payment policies, as well as their own billing and payment responsibilities.
Here are five tips you can use to improve the success of collection activities for your patient accounts.
1. Current And Accurate Database Management
One of the best methods for initiating better patient collection practices involves the management of your database. When the patient calls to schedule an appointment, your staff should obtain the basic patient information first, including the following items:
- Start by clearly identifying the specific reason for the visit.
- Record the patient’s name (as spelled on the insurance card), address, phone number (home and mobile), email address and preferred method of communication.
- Record the payer information, including type of plan, policyholder/participant name, identification number, policy number, and group/plan and telephone number for verification of benefits.
- Develop a pre-registration checklist that includes cost-share information, including deductible, co-payment and co-insurance information from the health insurance plan.
- And don’t forget to include HIPAA mandated information about who else you can talk to about the patient’s case and account.
2. Communicate With Insurance Companies
Many patient payment problems have to do with miscommunication about the procedures or treatment that will be paid for under the health insurance coverage. Take the necessary steps to ensure that your office has an open line of communication with the insurer.
Verify that all planned procedures and treatments have been pre-approved by calling the insurer and by reviewing the terms under their “Explanation of Benefits.”
3. Improve Techniques For Submitting Claims
Establish a clear policy for submitting claims. If you generate patient charges in “real time,” you can post charges immediately and send them to the payer within 24 to 48 hours. Conduct an objective analysis of your patient statement design.
It should be easy for the person to understand what they should pay.
Patient statements should also include aging of balance and customized dunning messages for delinquent accounts.
4. Maintain Friendly Customer Relations
An important aspect of the healthcare revenue cycle management involves keeping a friendly relationship with your patients. People choose you as their healthcare service provider because they appreciate your demeanor and the conduct of your staff.
Exercise patience when answering questions, explaining billing procedures, encouraging patients to pay on time and communicating with you.
5. Outsource To A Third Party Billing Company
Operating a healthcare facility, physician office or other medical professional practice has become more complex. When it comes to revenue cycle management, there are reams of contracts and rules, multiple payers to deal with, the need to track accounts receivables and other tasks that makes it increasingly difficult to manage in-house.
This can be complicated by the need for up-to-date training billing staff and the loss of key employees to turnover or retirement.