Insurance claim denials plague most hospital and medical practice billing offices, although to what extent can be hard to determine. There is a noticeable lack of information on the industry average for denied claims. Insurers are hesitant to release data about how often claims are denied, or for what reasons. So how can your billing staff know what to be on the lookout for when filing insurance claims?
Everyone in business, including those in the business of providing care, understands the importance of making a
good first impression, and following that impression with effective communication. Your patients are your customers, and their first impression of you is critical to the success of your healthcare organization.
Often references to the healthcare revenue cycle can be vague or over-broad, and as a result this critical element of an organization’s success can be oversimplified or misunderstood. The Healthcare Financial Management Association (HFMA) defines healthcare revenue cycle management as “all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.” It is so much more than billing and patient collections – the process actually starts the moment a patient calls to schedule an appointment. Get a glossary of common terms associated with the revenue cycle here.
We have shared much in the past about how to communicate better with patients. After all, better connections lead to better collections. However, one of the most important aspects of communication is not conveying your message; it’s listening to the patient’s.
Do you treat minor patients? Understanding your rights as a creditor and what you can and cannot do to collect a debt owed to your practice is already difficult, but when working with minor patients it can become even more so. One of our most frequently asked questions is:
“A patient received care as a minor and was under their parents’ care. If the patient is now of legal age and the parents still have not paid the bill, can we attempt to collect from the patient?”
Originally published in the September/October 2016 Issue of The PAHCOM Journal - www.PAHCOM.com
The culture you create within your office has a direct impact on how well your team is able to collect money, and it all starts at the top. It is up to the leadership within your practice to set the culture, and to hire and empower a team to sustain it. An emotionally engaged workforce leads to an emotionally engaged patient, which contributes to organizational success.