Physician practices are facing confusion and frustration due to the shift to value-based care and the ever-rising cost of care. Physicians seeking to stabilize their revenue amidst this chaos typically find themselves facing several challenges.
Collecting patient payments
Enrollment in high-deductible health plans is growing rapidly, leaving patients responsible for a larger portion of their healthcare bill.
When it comes to paying their balances due, patients expect the same consumer-grade experiences and conveniences they are accustomed to in other industries, where they can get same-day deliveries of their groceries or even purchase a car online. They also want greater price transparency.
Provider organizations, of course, are scrambling to meet these demands. They know that practices that can’t keep up with new patient demands are putting themselves at risk of losing revenue and eventually, patients, now that comparison shopping for healthcare services is on the rise.
Providing a range of electronic payment options—including online patient portals, automated payment plans and keeping a credit card on file—are all proven methods for improving the speed of payments, increasing payment processing efficiency and decreasing the cost of collections. Simultaneously, offering cost estimates at the time of a patient’s office visit can improve patients’ understanding of their responsibility as well as provide greater clarity around the cost of care.
Effectively tracking claims
Managing claims across a diverse set of payers and keeping on top of coding and compliance guidelines taxes even the most efficient revenue cycle teams today. They face a host of daily questions and challenges, such as: Are patients eligible for the services? What’s the status of a claim at any given time? How quickly can they process denials and appeals? Why can’t all claims be submitted electronically?
Ultimately, the key to claims management success requires the ability to collect more from payers quickly and with less cost and effort. Many practices use a claims clearinghouse to help manage this process and to provide dashboards with up-to-the minute claims information and can help reduce denials and days in accounts receivable while improving collections.