By Leo John
The healthcare revenue collection systems are evolving from simple payment collections to Revenue Cycle Management like Medicare value-based purchasing, collecting patient payments, readmission restrictions, and bundled payments. Expenses are also under scrutiny and require accurate costing data.
Medical Billing systems must be freed from the backroom and become a relevant cornerstone for preparing forecasts and capacity planning models that are all in one place to enable sound planning and decision-making. Healthcare providers should seek a common understanding of the business drivers and their effect on operations and economic profitability and cost.
Implementing streamlined and versatile payment collections, rigorously verifying insurance details, offering flexible payment plans, and training staff for effective communication collectively form a comprehensive approach to navigating the complexities of collecting patient payments. This blog delves into five indispensable strategies healthcare professionals can adopt to enhance the efficiency of collecting patient payments while maintaining positive patient and healthcare-provider relationships.
The Old Reimbursement Model
The traditional reimbursement model for healthcare providers primarily relied on a fee-for-service structure. Under this system, medical professionals were compensated based on the volume of services rendered. Each procedure, test, or consultation was assigned a predetermined fee, creating a straightforward but arguably unsustainable approach to healthcare compensation.
One of the major drawbacks of the old reimbursement model was its inherent focus on quantity over quality. Healthcare providers were incentivized to perform more procedures to maximize revenue collection, potentially compromising the emphasis on patient outcomes and value-based care. Additionally, this model often led to fragmented and episodic care, as services were billed separately, hindering the coordination of comprehensive patient treatment plans.
Furthermore, the fee-for-service model created challenges in collecting patient payments, as it did not inherently encourage efficiency or preventative care. The financial burden was often shifted onto patients, resulting in a system where individuals might delay or avoid necessary medical services due to concerns about out-of-pocket expenses.
As the healthcare landscape evolved and policymakers recognized the need for a more sustainable and patient-centric approach, the industry began transitioning towards alternative reimbursement models. This shift laid the foundation for the emergence of value-based care, focusing on the quality and effectiveness of services rather than the sheer volume, thus marking a departure from the limitations of the old reimbursement model.
The New Reimbursement Model
The industry has witnessed a transformative shift toward new reimbursement models in response to the evolving healthcare landscape and the imperative to enhance collecting patient payments while controlling costs. These models prioritize value-based care, focusing on the quality, efficiency, and coordination of healthcare services rather than the traditional Medical Billing. Here are five methods that represent the forefront of the new reimbursement model:
Discount from Billed Charges
Five Best Practices: Improve Your Patient Payment Collections
1. Accurate Collection of Patient Contact and Insurance Information
When patients initiate contact for appointments, ensure accurate and complete information collection. Staff are crucial in gathering patient details, including contact addresses and insurance information. Utilize Revenue Cycle Management software or online scheduling tools to facilitate seamless information gathering. Accuracy in patient records allows for efficient coverage verification, aiding the follow-up process during treatment and collections. Obtain necessary consent for electronic messaging, adhering to federal and state guidelines.
Go with the Best Medical Billing Software
Medical Billing Software can help you in collecting patient payments by tracking payment details, including past due bills, automating late fees, and identifying patients who are behind. Although purchasing Revenue Cycle Management billing software comes with a price tag, it’s a cost-saving approach and boosts your payment collections rate.
By incorporating these best practices into your healthcare Revenue Cycle Management, you can streamline collecting patient payments, reduce payment delays, and foster positive relationships with patients. Transparent communication, technological integration, and flexible payment options contribute to improving patient collections and an overall improved financial experience for both healthcare providers and their patients.