Bad debt is a major concern in the healthcare industry which can be brought on by a variety of circumstances. Providers accustomed to reporting losses as a result of these unpaid debts should consider employing a revenue cycle management company and use automated tools to improve collection recovery and ultimately increase cash flow.
The Montefiore Medical Center in the Bronx, for example, implemented an automated revenue cycle service three years ago as part of an effort to increase productivity and payment rates and also to reduce denials. "We believed that the operation of the revenue cycle had to change if we were to bring our performance to the next level,” said Jim McNiff, Montefiore’s associate vice president of health services receivables. “By using intelligent software,” he added, “you can eliminate errors and denials.” McNiff was right, and in the first ten months, the hospital eliminated more than 100,000 denials and reduced write offs by $15 million. By automating both ends of the revenue cycle and taking a more proactive approach to the medical collections process, providers can focus on patient care, while still ensuring that fewer accounts are left unpaid.
Verify information up-front: Through the implementation of automated tools, insurance information can be verified prior to a patient being seen, which can help to save staff valuable time and resources. Important insurance details which can be recovered include the patients' coverage type, benefit limits and co-pay amounts, whether a patient qualifies for charity assistance or if they require an alternate payment plan. Getting thorough financial information from patients up-front makes it easier to collect efficiently once the patient is discharged and can help to reduce the likelihood of claims denials.
Focus efforts on accounts most likely to pay: For patients who have already received treatment and have outstanding debts, collectability scoring can help review accounts to determine which patients are most likely to pay. Collectability scoring is a process that prioritizes patient accounts on 80 different attributes and ranks them on a scale to help the staff determine which accounts need worked the most. In addition, automated revenue tools can re-evaluate aging accounts for errors that resulted in lack of payment.
By employing a revenue cycle management company, providers can focus on patient care and designate the administrative side of the business to medical collections experts.
This information is not to be construed as legal advice. Legal advice must be tailored to the specific circumstances of each case. Although we attempt to provide up-to-date information, laws and regulations often change. We make no claims, promises, or guarantees about the accuracy or completeness of this document.For legal advice, please consult an attorney.