Are Your Front Desk Collections Helping or Hurting Your Practice?

July 20, 2016 by Ango Mark Leave a Comment

It is possible, depending on the practice size, you could be missing out on up to $100,000.00 dollars each month with little effort. Is this startling news to you? Have you done an analysis of what you should be collecting for co-pays? Have you compared this to the actual collections?

Co-pays

Co-pays are an integral part of the managed care program. You get a capitation check each month for the members you have in your practice. You are then expected to collect that co-pay for each member as they use your services.

YES, I said “EXPECTED.” These co-pays are contractual obligations made by the patient when they signed up for their care. The managed care program is expecting you to be collecting this fee every time they are seen for a covered service. They base their fee reimbursement and your capitated check, in part, on those monies.

In many practices I have analysed, the front desk does not even broach this particular subject. Why? Usually, because there has been no expectation of this collection explained to them. This is a subject that must be explained and taught upon hiring and periodically reviewed both through observation and formal educational activities later in employment.

Educating patients is mandatory

The specific amount of patient education that must be built into this. Many patients do not know or understand what a co-pay is. Gentle explanations with reference to their insurance cards for guidance can usually clear this up. Explaining the importance of payment AT THE TIME OF SERVICE is the one concept that MUST be emphasised. This is many times exactly how the contract is written.

Think about this fact: It cost you approximately $8.45 to send and collect on monies owed. The more notices, the higher this figure goes. When co-pays are $5 or $10 you are losing a lot of money. When co-pays are higher, there is still a financial loss that could have easily been avoided.

This article will help you achieve your financial goals by pointing out the tried and tested methods that successful group practices follow.

Stressing contract law is not the way to go, but mixing this information in with other things the patient can do to utilize their insurance to the best of their ability is a good first step. Writing reports and analyzing the biggest managed care programs your office works for is the beginning of the process. Medical Billing Services can help with running and analyzing these reports.

Nowadays these companies are capable of working with several popular EMRs, such as eClincalWorks™, NextGen™, ADP Advancedmd™, Greenway™, Care 360™, Allscripts™, AmazingCharts™, Epic™, and several more. Once you know who the payers are, putting together patient literature can easily be accomplished with your insurance representative from that plan. They may even have information ready to go in flyers for you.

At MedicalBillingStar We can go a step further and assist with the training of your personnel and write scripts that are effective, professional, and consistent across the board with each employee in the office. We are here to help!!! Collecting money legally due to you is why we are here! Give us a call to see where we can assist today. MedicalBillingStar can bridge that gap between the payers and doctors office collections team.

How your group practice can handle physician credentialing challenges

June 14, 2016 by Ango Mark Leave a Comment

Physician credentialing remains a big, blind spot for group practices. Non-credentialed providers add another layer of complexity to the fragmented and convoluted revenue cycle of group practices.

Studies reveal that more than 25 hours are spent on the credentialing process per provider. And a single physician takes more than 40 hours to handle his/her enrolment process. High days in enrolment, is another major issue faced by group practices.

The costs and time associated with credentialing, drive group practices round the bend.

But credentialing is a necessary evil. It is not just a simple, inconsequential form you fill out and forget about. The varied credentialing processes followed by insurers, critical deadlines and the uncertainties surrounding the system make it mission critical for group practices.

A slipshod credentialing process will result in…

Unrecovered revenue
Delayed or denied payments
Compliance issues
Strained payer-provider relationship
AR backlogs

Oops, that’s a lot of money!

Here is a ballpark figure of the credentialing costs for a multi-specialty group consisting of 10 physicians.

Initial cost of establishing the group’s physician credentialing file	$350.00
Initial cost of setting up the nurse practitioners credentialing file	$250.00
The cost of mapping to the physician state uniform app	$100.00
The cost of mapping to the state uniform app of nurse practitioners	$100.00
Initial credentialing charges for 10 physicians at $150 each	$1,500.00
Credentialing cost of 4 NPs at 145 dollars each	$580
License costs	$190.00
Total credentialing cost	$2970

With the high costs involved in the credentialing process it definitely makes sense to rework existing procedures, to more streamlined ones, to survive in the present-day healthcare space.

Red flags you shouldn’t miss…

The top credentialing problem in group practices is information errors during the credentialing process. As several physicians are involved, loss or mismanagement of information is de rigueur. Breaks in service that are not accounted for can severely handicap the credentialing process. And, so do, gaps in insurance coverage.

Physicians who have neutral reference letters can also dampen the credentialing procedure. The increase in on-boarding provider volumes in today’s environment of acquisitions has made it imperative, to have an efficient credentialing management process in place. A thorough verification and background checking process while adding a new physician to the group will reduce information errors and credentialing bottlenecks in the long run.

Follow these strategies to ensure timely and successful credentialing at your group practice…

Here we described a practically successful workflow to offer flawless credentialing solutions for your group practices. You can download the step by step credentialing guide here.

Not just the credentials of the individual provider who needs to be credentialed include the details of every physician listed on the CAQH roster and your group agreement during the credentialing process.
Furnish the contact details of the practice manager or group administrator of your practice.
If there is a single point of contact for the all providers in your group practice mention it in the form.
While credentialing a new physician candidate link the start-date of the provider to the paperwork submission.
In case of a change in your group name fill out and submit the updated W-9 form to the payer.
Understand that the credentialing process differs across different states. Follow state specific regulations.
Include accurate and updated mailing addresses credentialing details and all other important communication reach the appropriate recipient.
Use the Q-6 modifier to bill new providers who’ve joined your group as locum tenens. But some health plans do not accept this method. Thoroughly scrutinize the insurer’s regulations prior to billing a new provider as locum tenens.
Make sure that the health care providers joining your group practice complete the Universal Credentialing DataSource credentialing application (UCD).
Ensure that every provider in the group re-credentials within stipulated deadlines to avoid cancellation of privileges.

All new dictation and medical documentation app for healthcare organizations

December 28, 2015 by Ango Mark Leave a Comment

MedicalBillingStar launched a dictation and medical documentation app for physicians on Thursday. Dictastar is a medical dictation app that is specifically built for Android/iOS users. The application is thoroughly HIPAA compliant and has been successfully integrated with several EHR systems.

“It can save physicians the hassle of transmitting and following up on dictations. It is basically a one tap app that covers all the bases as far as dictating and documentation is concerned”, says Steve who is a co-developer of the app.

MedicalBillingStar. popular for its revenue cycle management services has forayed into the burgeoning healthcare app market.

“Though our core business is offering medical billing, medical transcription and revenue cycle management services to healthcare organizations, we’ve forayed into the mHealth marketplace due to the unprecedented demand for healthcare apps. Most of our clients wanted a better and easier way to dictate and document medical records. Dictastar is our answer”, adds Steve.

The dictation app simplifies the usually circuitous medical transcription process. Dictastar interfaces with the EHR of medical practices. And accesses and stores the appointment information of physicians. Prompts for entering patient name and type of document i.e. discharge summary etc.., enables users to eradicate documentation errors.

“It reduces documentation errors. One common mistake physicians make is forgetting to mention patient names during the start of a recording” says, Steve.

According to Steve, Dictastar automates a workflow process that “can certainly do with automation”.

“We understand that the primary concern of healthcare organizations is data security. Dictastar is highly secure. It complies with all national guidelines for data security. It is HIPAA and HL7 compliant. The robust security infrastructure and data encryption protocols, guarantee best of class data security” Steve adds.

“It will free physicians from the ordeal of being glued to their systems for the most part of their workdays. Being able to send dictations and receive transcripts through their smartphones is possibly the best Christmas gift we’ve given our clients” Steve says.

Dictastar can be downloaded from the iTunes/Play Store

About MedicalBillingStar

MedicalBillingStar. is a revenue cycle management and medical transcription services provider based in Florida. It offers diverse products and services that are aimed at simplifying and maximizing the efficiency of the everyday workflow of healthcare organizations.

The Critical Role Of Hospital CFOs: A Data Driven Answer [Infographic]

October 5, 2015 by Erika Regulsky Leave a Comment

We know the evolving role of CFOs in the healthcare industry. There are situations which have forced the executives to make such decisions like changing the vendor, attritions and outsourcing one or more of their processes. There could be ample reasons like transition to value-based model, slow payer procedures, low Medicare and/or commercial payer reimbursements, ICD-10 etc.

Let me break this down into a data driven answer but before I want to share with you what medium and large healthcare organizations believe:

What do CFOs of medium healthcare organizations believe?

They make decisions as to clinical efficacy first and then cost management.

If a service is too costly to keep, there is consideration to drop the service as it deters from other services which are accretive to a positive margin.

What do CFOs of large healthcare organizations believe?

They focus on key opportunities for improvement

They put sufficient resources behind efforts to implement and hardwire improvement.

They don’t try to do everything at once.

Here are some facts and surveys which highlight the financial challenges of our healthcare industry leaders:

Click on the image below to enlarge:

The Critical Role Of Hospital CFOs: A Data Driven Answer [Infographic]

8 Hospitals bankruptcy facts, know to avoid!

August 13, 2015 by Ango Mark Leave a Comment

“We shouldn’t feel sorry for ourselves. A lot of us say, oh my God, how could this be happening. Look at all the unpredictable things happening all the time.These are happening in every industry.”Michael Dowling, CEO of Great Neck

This June didn’t work well for some healthcare systems. Many hospitals struggling financially for years were forced to announce their failure. What could have made these hospitals suffer major revenue losses and file for bankruptcy protection? Let us check the most recent ones who had to face such setbacks and challenges and what you can learn from them.

5 facts I bet you don’t know about Kona Community Hospital!

The hospital announced that it would be eliminating 34 positions and shutting down its 18-bed skilled nursing service according to KHON
According to officials, a contingency plan to file a $6 billion budget shortfall which came partly by increased costs of collective bargaining and retiree health benefits resulted in planned cuts and closures.The costs were paid by the state in the past.
KCH had to face reductions also due to the Hawaii Health Systems Corporation(HHSC) corporate-wide reduction in force and services which was targeted to address a $50 million projected deficit for the entire HHSC system for the FY 2016.
Employees who lost their positions due to layoffs will be placed in a budgeted vacant position.
The 18-bed skilled nursing unit could be reopened in the future if required.
What made Victory voluntarily file under Chapter 11 of the U.S. Bankruptcy Code?

On June 12,2015,the Texas based Victory Healthcare which manages six for profit medical and surgical centers, filed for Chapter 11 of the U.S. Bankruptcy code. Nobilis, a Houston based health system agreed to take over Victory Medical Centre in Plano, Texas for which Victory has reached the court to accelerate the sale. Victory stated it has “many interested buyers for its centers”.

Victory Medical Centre Beaumont and Victory Medical Centre Houston-East are the two centers not included in the filing. These centers don’t need the court process because they have buyers in place.

“We had built an extremely high quality, state-of-the-art group of community-centric medical centers and hospitals,” said Robert N Helms,Jr.,Chairman and CEO and Manager of Victory. “Unfortunately, as out-of-network providers, we came under attack by large insurance carriers. Even though we were able

to execute in-network agreements with three large insurers, the extreme slowness and lack of payment from the carriers constrained liquidity significantly.”

To overcome these challenges, Victory had to cut down on expenses, reduce services but they did not close their emergency rooms.Mr. Helms said, “Unfortunately, now we have no other choice except to sell our facilities with the intent of remunerating secured and unsecured creditors alike.”

Some information about the filing:

Parkview Adventist files for bankruptcy, eyes for merger!

The Brunswick, Maine based medical centre on June 16,2015 filed for Chapter 11 bankruptcy, reported by WCHS6.Randee Reynolds,Parkview President said, “This is not a shock to anyone that’s been here at Parkview. You can only go so far.”

According to officials, the healthcare system, after struggling financially for years, closed its inpatient care and emergency department.Mid Coast Health Services will be getting these 2 services on merger and it will also employ its 180 FTEs.

Brief information about the case filed:

3 lesser known facts about Palomar Health!

In a 5-2 vote by Hospital directors on June 24, the Escondido, C.A. based Palomar Health Downtown Campus is set to close and shift its existing patient care to sister facilities in 90 days.

This downtown campus which has 850 people working, houses labor and delivery department, inpatient rehabilitation, behavioral health care, a reserve emergency care and few outpatient surgical services. The Poway based Palomar Medical Center and Pomerado Hospital will be taking over those services.
Following the patients to the new Poway facilities will be the clinical workers such as nurses and technicians, while those losing their jobs will be support workers. The Palomar’s CEO estimates that between 60 & 75 FTEs and an added 180 to 220 “per diem” part-time workers have to give up their jobs.
As reported by The San Diego Union-Tribune, due to $20 million operational losses a year and requirement of more than $162 million maintenance costs, the healthcare executives at Palomar recommended closing the downtown medical centre.

What forced Kindred Hospital to target layoffs?

Following the end of Kindred’s lease in Natick by MetroWest Medical Center, the hospital in Boston is aiming layoffs as reported by the Boston Business Journal.

On June 26,2015 the 60 person Kindred hospital, which is part of a larger organization of transitional care and other types of hospitals, closed formally soon after its master the Metrowest put an end to the lease

“We explored several options to move Natick to another location, but determined it was not feasible,” said Amber Hester, Chief Executive Officer at Kindred Healthcare. “We are confident that we will continue to serve the community through our other Kindred hospitals in Boston, Stoughton, and Peabody and our additional lines of service.”

“Almost half of the workers at Natick got jobs at other Kindred centers in M.A.”, Ms, Hester told the, Boston Journal .And her healthcare organization continues to work with employees on finding appropriate jobs.

Kindred is well known for reducing admission rates by 8.4% from 2008-2011.

Why Partners Health decided to cut jobs, closures?

1.In the reestablishment of the NSMC wing of Partners healthcare, all the inpatient services located at Community Hospital will be consolidated at the Salem Campus over the next three years

2.The North Shore Medical Center will rebuild the emergency department, provide,additional 58 beds and 50 new beds for behavioral health.

3.The hospital executives said this plan will target 100 jobs.And they believe to achieve the job cuts through attrition rather than layoffs, according the reports.

4.There’s no date set by the officials for closing the Lynn campus hospital.But the emergency department will be there for over 3 years, and a medical practice with the strength of 16 physicians will stay there.

5.Local residents have opposed the decision to close the hospital as they don’t want to see critical medical services shut down. However officials at NSMC believe that this approach would improve patient care at the more advanced and wide ranging Salem campus.

6.The Union hospital was finding it tough to attract patients and thus couldn’t afford to employ specialty care, particularly doctors who specialize in different cardiology types.

7.Due to Medicare and Medicaid insufficient reimbursements both Lynn and Salem lost more than $20 million last year according to Robert G. Norton, president of North Shore Medical Center. Of the patients visiting the Centers, Medicare and Medicaid patients are about 60%.

8.The losses by NSMC over the years were subsidized by Massachusetts General, Brigham and Women’s, the organizations successful wings.

9.One major reason of the medical centers’ plan to close came from,Partners putting their decision on pause, to acquire Hallmark Health Systems.The expected cost savings with the consolidation is to be $18million per year.

Why did Jameson end its Maternity services?

On July 23,2015 New Castle,P.A. based Jamison Hospital announced that it will no longer be providing maternity services with effect from September 1st.

One of the reasons is the uncertainty of the merger of Jamison hospital located in New Castle into the UPMC network. In February the merger was given a formal nod. The officials were expecting the much needed regulatory approvals from Pennsylvania Attorney General, which didn’t happen.

The childbirth services were maintained appreciably well only by two obstetricians for over nine months. It forced the hospital to close its childbirth services when one of the two obstetrician decide to shift her practice to another hospital.

If any OB services arrive after September 1st to the emergency room, the team at Jameson will assess,provide emergency care and transfer appropriately.

The additional staff of childbirth center will be offered to bid on positions available in other wings of the organization.

Michigan’s only independent hospital files for bankruptcy!

In their chapter 11 petition filed last month in Detroit, the Pontiac based Doctors Hospital pointed debts between $10 million and $50 million

The doctors hospital was unable to bear the financial losses it received between 2009 to 2013.The physician-owned hospital listed a loss of $11.9 million on net patient revenue of $63.8 million, the latest financial data available, according to the report.

The hospital tried to cut expenses all these years by shutting down its emergency department in October 2013 and targeting 40 layoffs out of the hospital’s 200 employees.But the hospital couldn’t do more to prevent losses and is now under pressure from its investors.

An example of how a petition form looks like:

Pro Tips:

What forced these healthcare organizations to file bankruptcy, target layoffs and service closures?

Attack by large insurance carrier on out-of-network providers
Struggle to attract patients,
Low Medicare & Medicaid reimbursements rate
Uncertainty or failure of a merger.
Shortage of specialists such as an obstetrician or cardiologist
Consecutive revenue loss and pressure from investors.

There could be more reasons to force the executives to close a service, file for bankruptcy and target layoffs. When it comes to cutting operational costs, get your employees to identify cost saving opportunities and reward the ones who come with best ideas.

The slow payment process of payers creates a massive revenue backlog. The payers have to implement strategies to improve their payment process.

4 tips from organizations which experienced value of growth from mergers:

Combine a growth strategy of acquisition and new development.
Analyzing acquisitions for all the pieces of coordinated care will help you determine the results.
To form a single system culture compare centralized system leadership with site-based local leadership.
To fit the organization’s mission, vision and values learn how to identify physician partners and potential hospitals

Healthcare organizations have to take a chance to invest in the expansion of a specialty line. Though the investment is more it will provide valuable care and boost the revenue of the center. Organisations who rely on two or three specialists will be forced towards service closure.

For hospitals that face consistent revenue loss, the best choice would be outsourcing the revenue cycle management to a service with proven expertise.

What actions are you going to take to assure you don’t get listed as one of these hospitals?

Drive up operational efficiency with these business intelligence tools!

April 23, 2015 by Ango Mark Leave a Comment

The healthcare ecosystem is fragmented, complex and forever evolving. To stay on top of changing challenges and reforms, an increasing number of hospitals are turning to business intelligence tools. BI tools eliminate hazy guesses, redundant processes and workflow inefficiencies.

Healthcare business intelligence tools enable better decision-making and accountability.

6 amazingly efficient BI tools that no medical practice should be without!

Dimensional Insight’s Diver

Dimensional Insight’s Diver allows you to analyze and assemble the external and internal sources in a single view. This software BI tool comes with an integrated web-based suite with many features like dashboards, scorecards, alerts, and interactive reports. The enterprise -wide reporting and analytics platform indicators are delivered to the specific users like hospitals, chief financial officers or clinical care administrators.

Pandora Suite

The Pandora suite software allows analysis of the medication and supplying distribution throughout the health care organization. The tool allows tracking the costs for each patient visit and also prioritizes their issues like compliance, lowering costs and addressing operational issues. It is also used to identify suspicious activity and canceled medication transactions for clinical operations. With the help of Pandora analytics tool, the healthcare organizations assist in drug diversion prevention, regulatory compliance, and inventory optimization.

IBM’s Cognos

The IBM’s Cognos BI tool offers features that aid in patient care and business performance. To measure the performance of an organization, IBM Cognos allows users to create scorecards. These scorecards will track the performance of key performance indicators. Healthcare organizations can gain insights into the different processes that make up the everyday workflow of healthcare systems.

QlikView

QlikView BI tool helps healthcare organizations to analyze huge volumes of business data. This QlikView helps hospitals to monitor and to improve performance within various functional areas like clinical operations, care delivery, resource planning, finance and revenue cycle, the executive suite, and supply chain management.

Oracle suite

Oracle suite BI tools help providers, to derive complete value from clinical and operational data for financial and operational performance. The Oracle suite integrates data from electronic medical records, clinical departmental systems, patient accounting, enterprise resource planning, research, and other systems.

theBillingBridge

theBillingBridge, is a business intelligence, and, reporting app, specifically built to work with Android and iOS powered devices. It has a user-friendly interface and offers highly analytical reports and dashboards. BillingBridge offers on-demand financial reports. It makes tracking key performance identifiers and setting benchmarks easy. Detailed reports about claim submissions/rejections, breakdowns on insurer payments, coding details and payment analytics are provided. Users can send queries within the system. Proactive alerts can be set.

8 ground-breaking mHealth apps for medical professionals!

April 21, 2015 by Ango Mark Leave a Comment

mHealth apps have created a stir in the healthcare industry. Thy have enabled better communication between patients and physicians and have driven up a patient engagement to some extent. A study reveals that about 70% of people use mHealth apps.

Here are 8 mHealth applications that are getting a huge thumbs-up from the physician community.

A whole world of information…

Explore prescriptions and safety information of, thousands of, generic, brand, and OTC drugs with Epocrates. This is a splendid mHealth app where you can check for harmful drugs and its interactions. Physicians can execute lots of calculations like BMI and GFR. It also helps physicians to key out pills by physical characteristics and imprint code.

Stay up to date!

Physicians can rely on UpToDate app for drug topics and recommendations as it is connected with hospital execution and patient care. The UpToDate app comes with a persistent login, mobile-optimized medical calculators, and many other super-smart features.

Your peers love this…

An exclusive app that is designed for physicians, Doximity is used by 50% of the physicians in the US. It is a medical professional networking app. This app facilitates HIPAA-secure communication, and updates about healthcare news, career management and much more! Physicians find this app very useful as they can receive and send HIPAA compliant faxes from their smartphones, tabs, laptops etc…

Read up on the vital info!

A huge collection of personal articles by physicians is organized, and can be reviewed, with Read by QxMD. Physicians can browse any number of topics and share the articles via social networking platforms. Read by QxMD will provide you full-text PDFs and physicians can get access to institutional or open access publishers.

Stay on top of the ball…

The New England Journal of medicine is specifically meant for physicians and medical professionals. This app contains the latest findings in the medical field. Medical professionals can view images of medical conditions from Clinical Medicine. NEJM This Week allows physicians to streams four procedure videos in clinical medicine.

Why Isabel?

Isabel app is used by physicians around the world as it helps to search diagnosis of multiple signs and symptoms of more than 6,000 diseases. Physicians are allowed to check the availability of diagnosis through their web at www.isabelhealthcare.com. Isabel app is the best tool for physicians for the diagnosis process.

The go-to app of 150,000 healthcare professionals…

The Figure 1 – Medical Images are used by 150,000 health care professionals. It allows medical professionals to interact with other colleagues online. This app helps to improve the knowledge of medical professionals as they can discuss diagnosis and treatments. Physicians can easily get the clinical images of de-identified patient photos, x-rays, charts, MRIs and CAT scans.

Be in the know!

Medscape is a must have app for all medical professionals as physicians can visually identify drugs, OTCs, and supplements. This app provides answers for almost all clinical related questions. Medical professionals can find useful articles and Medscape also offers medical calculators, a rich collection of images, information on new drugs, and more. With the drug reference tool, physicians can find dosages and medications for evidence-based diseases.

The top 4 medical coding tools!

April 8, 2015 by Ango Mark Leave a Comment

It can be incredibly frustrating and laborious to assign medical codes. The complexity of the medical coding process has increased manifold due to the latest healthcare reforms. There is demand for perfect documentation. Anything less than perfect, means, rejected claims, or, worse still, fines for miscoding.

Automate: The sooner the better!

There has to be a better way to code. Right? Well here is the solution, automate. Using tools to code can help in streamlining and quickening the medical coding process.

4 super-efficient medical coding tools!

1.Turbo Coder:

Turbo Coder is a digital coding tool that is user friendly. This tool includes ICD-9CM, ICD-10CM, HCPCS and CPT codes. The Turbo coder has truckloads of smart features such as, pre-emptive search spelling help, spell checker, main term search, annotation and notes, multi screen view where you can view four sections at the same time. And the most important feature, security! Turbo Coder is an excellent adjunct tool that helps with coding visits. This digital coding software has indexed digital content as well.

2.TruCode:

It is a feature rich tool that helps to eliminate claim denials, due to coding errors. TruCode promotes coding accuracy. It automatically presents critical coding information within a single encoding screen. TruCode helps in bettering coding outcomes.It has a neat interface and is easily navigable.

3.3M™

Improve the quality of your clinical documentation with the 3M™ tool. This 3M™ tool enables accurate coding and streamlines the outpatient and inpatient coding process. Maintaining quality metrics and achieving appropriate reimbursement for services is easier with this software. 3M™ coding tools helps in adding greater specificity and accuracy to coded data.

4. BillingBridge

Want to know what your top paying codes are? Know what works! BillingBridge is a code analytics app that helps users to view their top performing CPT codes, most used codes and frequently made coding errors. It helps medical coders to make course corrections and systematizes the medical coding process. It has an uncluttered interface and informative dashboards. Inbuilt query tracking and chat support is also available.

Stop denials to a large extent with the help of these smart coding tools!

Dismal patient collections? Make sure you aren’t making these 5 mistakes

April 1, 2015 by Ango Mark Leave a Comment

Are you making these 5 common mistakes?

There can be nothing more discomforting than talking to patients about payment responsibilities. Coverage cuts and high deductible healthcare plans make it imperative for healthcare organizations to focus on patient collections.

But do you feel queasy every time a patient collection issue crops up? Avoiding these 5 mistakes and training staff to steer clear of them, can boost your patient collections.

1. Giving the wrong signals!

Body-language matters. Smiling, while discussing about payments, can signal to your patients that you aren’t serious, or undermine the importance of paying the due amount. Frowning or speaking in a grave tone can put off patients. Maintain a neutral body language throughout. Familiarize yourself with contractual terms and coverage details before the discussion. Fumbling or giving the wrong information will further prolong the entire process.

2. Sending out overly complex patient statements…

You can bet your bottom dollar that most patients are not familiar with insurance terminology. So don’t send out a statement that can only be understood by a biller or insurance expert! Simple patient statements that don’t overwhelm patients work best. Don’t add aging buckets at the end of the statement. It can be an open invite for patients to procrastinate payment.

3. Let the patient speak!

Most medical offices make the mistake of dominating conversations with patients. Let the patient speak. More often than not the amount they agree to pay or the deadline they agree to clear bills will be much better than what medical practices expect! Encourage patients to come up with suggestions, payment options and payment schedules. This way, patients feel less browbeaten and more involved.

4. Not exploring newer methods for collecting payments…

A lot many medical practices are implementing the “credit card on file” program. The details of the credit card are securely stored and the medical practice “swipes” the card to recover payments due, if and when required. Discover new, convenient and patient friendly payment options.

5. Missing out on upfront collections…

Failing to capture upfront collections complicates and delays the patient billing cycle. Ensure your front-desk staff, collect desk payments promptly. Call patients prior to an appointment to inform about their payment responsibility and what method of payment would suit them best. Have a swipe machine or request patients to pay online.

Provide a receipt, and if possible a note of thanks, upon receiving payment. This will induce patients to more promptly the next time around.

How effective is your billing team while negotiating payer contracts

November 6, 2014 by Ango Mark Leave a Comment

Contract negotiation: Start on the right foot!

You file claims regularly and follow up on them diligently. But why are the collection figures so dismal? It becomes a challenge to make ends meet and make a decent profit. Don’t look at your collections report. The cracks lie elsewhere and it’s never too late to make course corrections.

Payer contracts are usually overlooked and this oversight can cost your medical practice thousands of dollars a month. The major reason why negotiating payer contracts are usually never paid the attention it deserves, is because of a convoluted process that can take months on end to reach fruition.

At a busy medical practice nobody has the time to pore over contractual agreements, deduce fine-print and follow up with insurers. But medical billers should pay attention to payer contracts so revenue doesn’t slip through the cracks.

Are you making these 5 contract negotiation mistakes?!

#1. Not getting out unproductive contracts can put practices at a serious disadvantage. Billers should educate medical practices about how some “evergreen” contracts that get automatically renewed are detrimental to the organization and the procedures to break away from them.

#2. Most medical billing teams or firms do not run comparison reports with other medical practices. Not doing so can result in a stagnant revenue cycle and archaic payment structures. It is essential to keep an ear to the ground and change contracts according to recent payment regulations.

#3. Most billers do not perform consistent revenue analysis. Reimbursement analysis has to be performed regularly to check if the current prices are not outdated or under-priced.

#4. Payment models will have to be chosen according to the workflow, patient population and compliance requirements of the clinic. Contacting insurers and performing contract negotiations beforehand can actually be counter-productive.

#5. Not following up regularly with insurers regarding contractual changes is another major flaw. Medical billing teams or companies should follow up regularly with insurers to wrangle out the best possible contract.

Quick tips from the experts…

Foster relationships Like physicians, health insurers are under pressure to control costs and improve quality of care, and you can help them achieve those objectives.Discuss about areas of concern and how you can join hands to contain costs and improve quality of care

Stand out from the crowd The geographical location, size and specialty of a medical practice can affect the value an insurer places on your business. Look for what sets your medical practice apart and use it as your USP to negotiate better payments.

Read the fine print Make sure there is an annual renewal option . Also, pay attention, to notices of changes from your insurer. Every communication from the insurer should be scrutinized as it can contain important reimbursement information.

Beware of silent PPOs A silent preferred provider organization (PPO) can access discounted rates for services without your authorization, preventing you from billing patients for amounts above the contracted fee. So beware of them!

Source: http://www.physicianspractice.com/revenue-cycle-management/payer-negotiation-little-preparation-goes-long-way

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Lisa Maciejewski-West
CMC, CMOM, CMIS, MCS-P

Medical Billing Services | Medical Billing Company Checklist

Are Your Front Desk Collections Helping or Hurting Your Practice?

How your group practice can handle physician credentialing challenges