10 Payment Collection Strategies That Work

10 Payment Collection Strategies that Work 10 Payment Collection Strategies that Work

Claims clearinghouse and revenue cycle management vendor Availity has new guidance for physician practices and hospitals to optimize payment collections, particularly in the area of higher patient payment responsibility. (Photo: Fotolia)

Optimize Pre-Appointment Workflow Optimize Pre-Appointment Workflow

Verify insurance eligibility and authorization prior to an appointment. These checks should become part of the regular workflow and supported with patient liability estimation software to know how much to collect up-front. “Industry best practice is to verify 98 percent of patient eligibility and benefits prior to every visit, but few practices consistently check this information,” according to the guidance. (Photo: Fotolia)

The Importance of Patient Statement Design The Importance of Patient Statement Design

Patients who don’t understand their bill are unlikely to pay. Join the Healthcare Financial Management Association’s Patient Friendly Billing initiative. Communications should be written in clear language, be concise with the right amount of detail to communicate the message, and should be correct without estimates of liabilities. (Photo: Fotolia)

Set Payment Expectations Early and Often Set Payment Expectations Early and Often

The odds of being paid appropriately drop by 62 percent once the patient leaves. Make it a regular practice to ask for payment and collect it at the point of service. “Top performing practices don’t just ask if a customer would like to pay today, they ask how.” Train staff on the best approaches; they could find it difficult to ask friends, neighbors and hard-luck cases for payment. (Photo: Fotolia)

Convenience Makes it Easier to Pay Convenience Makes it Easier to Pay

Most facilities and billing services offer an option to pay by credit card on statements, but also offer an online payment option. Look for options that support automated monthly debits for payment plans to reduce reliance on a patient taking action every month. Add an automated option to your phone menu and remind patients of appointments and balances via email or text messages. (Photo: Fotolia)

Invest in Training Invest in Training

Professional associations can be a good source for training. Evaluate if your onboarding is effective or whether you need to look at external resources such as on-demand training modules for customer service, insurance plan design and HIPAA compliance. Encourage or incent use of Web seminars, conferences and user group meetings. Establish a culture where continuous improvement is expected. (Photo: Fotolia)

Scrub Claims Clean Scrub Claims Clean

Hundreds of new and revised codes are introduced annually, not to mention upcoming ICD-10 codes. “A professional claim scrubbing tool can automate claim reviews to scan for compliance with National Correct Coding Initiative and other coding regulations and requirements--a review that, when performed manually, can be daunting for even the most experienced coders.” Use technology that builds coding rules into the practice management system, and checks and corrects errors prior to claims submission. (Photo: Fotolia)

Measure and Monitor Measure and Monitor

Comparative analytics enables productivity and performance comparisons against peers and by specialty on local and national levels. If analytics is not feasible, work to meet key performance indicators. Aim for an overall denial rate of less than seven percent, a bad debt rate of two percent or less, no more than 20 percent of accounts more than 90 days old, and net collection rates of at least 97 percent. Measure the time it takes staff to submit a claim after a patient visit and time from submission to payment or denial, measure denials due to ineligibility, measure coder productivity and compliance, and solicit patient feedback via comment cards and email. (Photo: Fotolia)

Be Aggressive with Claim Denials and Rejections Be Aggressive with Claim Denials and Rejections

Commercial insurers deny about 23 percent of claims, but less than half of those denied are reworked and resubmitted. That doesn’t included rejected claims that don’t go through adjudication. Have separate workflows to manage claims that need to be written off, need corrections and need to be appealed. Set daily and weekly targets for working claims and reward for high performance. Run an open claims report every 60 days to more aggressively manage aging claims and use online claim status tools to track resubmitted claims. (Photo: Fotolia)

Offer Financial Incentives and Discounts Offer Financial Incentives and Discounts

Offer discounts of 10-15 percent for paying up-front or in full within 30 days. Discounting rates for self-pay patients of around 25 percent or offering sliding scale pricing based on income can mean getting paid a portion of customer charges rather than getting nothing. Offer reasonable payment plan options. Some providers and insurers also are starting to offer health care gift cards. Incent staff for meeting billing and collection goals, but set specific measureable and realistic goals to avoid bad behavior. (Photo: Fotolia)

Timing is Everything Timing is Everything

Send billing statements within 24 hours of a visit. The right window to begin initiating collections activity is between 90 and 120 days; any longer and payment chances fall significantly. Have a written policy given to patients documenting measures your office may take to resolve accounts, and notify patients at least 30 days prior to collections action. The complete collections guidance from Availity is available here . (Photo: Fotolia)

Claims clearinghouse and revenue cycle management vendor Availity has new guidance for physician practices and hospitals to optimize payment collections, particularly in the area of higher patient payment responsibility.

 

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