One of the ultimate purposes of all healthcare Revenue Cycle Management services is shortening the AR cycle and ensuring payments are collected in full and on time. Collections are a challenge right now, with more insurance coverages requiring patients to share a part of the financial load. Healthcare organizations need to understand the payment responsibilities of the insurance payer and the patient and collect from multiple sources.
An internal medicine practice is a busy department that handles a steady inflow of patients with various health conditions. Having a solid billing and coding team is a strength that will help internal medicine practices get a grip on their revenues and grow steadily.
Here are five ways to help improve collections for your internal medicine practice that would streamline the revenues generated and help your staff know the right things to do when easing collections.
1. Focus on documentation and prior authorization
One of the basic requirements of better collections is having precise documentation in place and checking for prior authorization cases in advance.
Documentation is one of the first steps in the Revenue Cycle Management service that helps streamline the rest of the processes in turn. Getting information on the insurance coverage, the type of medical plan the patient has, and copay details will help the hospital understand the collection process.
If the patient’s medical plan has a copay section, it will help inform the patient in advance, so they come prepared too. This would increase the chances of the hospital getting paid on time.
Prior authorization is essential in some cases; without this, the insurance payer may refuse to reimburse for the services already provided.
2. Have strong payment policies in place
Well-planned payment policies help your frontend team go through specific processes when it comes to payment collections. These payment policies tell the staff what to do from the minute a patient calls to book an appointment up to receiving payments and co-payments.
These policies also include scenarios and what to do for each case, making it easy for the front-end staff to contribute to the collection operations. For instance, the policies tell when to send the first payment reminder, when to follow up with calls, and what to do when patients delay making their part of the co-payments.
Such payment policies are part of strong Revenue Cycle Management services, and these definitely need to be a part of all healthcare backend operations.
3. Strengthen patient collectibles processes
New government guidelines have now increased the general co-payment part of medical reimbursements and require patients to shoulder some of their healthcare expenses. This means that hospitals now have to collect payments in two parts – from the insurance provider and the patient themselves.
A study reports that 20% of all healthcare revenues are copayments. However, not all healthcare organizations have in-built processes to handle copayments effectively as a part of their Revenue Cycle Management services.
Firstsource’s patient balance services help tackle this aspect of collections effectively and efficiently. Our tools instantly identify the copayment needs of patients and generate patient statements that support the front desk in confidently approaching the patient for reimbursements.
Having robust patient collectible processes helps in the following ways.
- Reduce AR cycle
- Eliminate bad debts
- Avoid the need to work with collection agencies
- Avoid the need to keep following up with patients for their part of the payment
- Eliminate the need for write-offs
4. Offer multiple payment options
When it comes to patient collections, the best way to encourage patients to pay on time is to allow for multiple payment options. Not all patients have instant cash to pay toward copayments.
A 2020 report by VisitPay reports that 37% of patients cannot afford to pay more than $100 towards sudden medical expenses every month. The higher the copayment value, the more likely the patients will pay them immediately.
Hospitals need to analyze the financial positioning of their patients and ensure they are not surprised by high-valued bills.
As a result, allowing patients to pay via credit/debit cards or cheques or even offering monthly payment plans for people in need can all help encourage patients to keep up their part of the financial commitment.
A report by TransUnion says that 99% of hospital bills that required the patient to pay more than $3000 were not paid in full. You can prevent this by helping patients make Equated Monthly Installments. Make changes to your Revenue Cycle Management services to help accommodate this.
5. Do not forget to work on other aspects of your Revenue Cycle Management services
The fifth most important way to improve collections for your internal medicine practice is to focus on the other aspects or operations of your Revenue Cycle Management services. This includes precise coding, focusing on auditing and compliance, denials and rejection management, and using RCM analytical tools to identify process gaps and fill them.
Working with a third-party RCM service provider like Firstsource will help tweak your Revenue Cycle Management services every step of the way, improving them and affecting the collections at the end of the day.
Our AI-based tools are designed to shorten the AR cycle and automate most RCM processes so that you don’t have to intervene regularly to collect payments. Over time, well-designed RCM operations can act as solid foundations for the revenues generated and bills collected, helping your practice grow and flourish.
Takeaways
Collections are a direct impact on the revenues generated by hospitals. Ensuring there is a process to approach collections will help avoid having to write off payments or lose money thanks to denials.
Firstsource offers Revenue Cycle Management services for healthcare brands that struggle to get a grip on revenue generation and patient balance collections. Contact us to know what changes to bring in to ensure bills are collected in total and reimbursements are made on time.