Revenue Cycle Management Series: Collecting From Patients, Insurance Payers

The final installment of the HMS Healthcare Management Solutions series on Healthcare Revenue Cycle Management Developing strengths when collecting from patients and insurance payers is important to a strong revenue cycle management.  Below are some tips to make the process an easier one.

Collecting From Patients:

• Be Assertive: Patients are responsible for knowing co-pay amounts and should be prepared to pay at the time of service.
• Be Consistent: Request payments at the time of service, submit timely collection letters and make phone calls as soon as payments fall behind should be standard practice.
• Provide A Solution: Always provide options such as payment by credit card or short-term payment plans. Help patients qualify for federal assistance when appropriate.
• Give A Discount: Consider a reduction for paying a balance by a certain date. Not only will it help close the account, but it will increase the chance of collecting payment.

Collecting From Insurance Payers:

• Submit claims as soon as possible after services have been rendered
• Submit claims electronically whenever possible
• Submit claims properly
• When adjudicating claims, give priority to rejected or denied claims
• When disputing a claim, be sure to talk to someone with the authority to make a decision
• Involve the patient to speed up a claim determination if necessary

Tiptastic Tuesday: Physician Practice Collections

Reimbursement issues can cause fluctuations in revenue while payer and contract problems can result in revenue reduction.  Look for the following elements if and when cash receipts look unusual:

• curious charge activity in previous months
• payments no posted regularly
• lost claims
• payer adjudication issues.

Remember, reports can be run from your practice management system to identify problems with a specific payer.  The sooner you find out the reason for payment delays, the sooner the problem can be resolved.

Monday Morning Recap

This week’s HMS Healthcare Management Solutions Monday Morning Recap offers a recap of last week’s healthcare highlights. Below are some of the stories you might have missed.

• Social Networks Improve Treatment
• Revenue Cycle Management: Write Offs
• Notable Changes To Final HIPAA Omnibus Rule
• Study Reveals Benefits Of Folic Acid
• Government Recovered $4.2 Billion in FY 2012
• Healthcare Trends Drive Patient Care Delivery
• Social Media Impacts Care Decisions

Revenue Cycle Management Series: Pieces of the Puzzle

HMS Healthcare Management Solutions kicks off our latest blog series, Healthcare Revenue Cycle Management with an overview of the pieces of an effective revenue cycle process.

Revenue cycle management begins as soon as a patient makes an appointment and doesn’t end until the account balance is resolved. There are several important steps in the process that must be understood and followed to ensure profitability.  Lack of attention to any of these can result in greater costs to collect revenues as well as decreased earnings for the organization.  Steps for effective revenue cycle management include:

• Appointment Scheduling
• Patient Intake/Registration
• Charge Capture
• Billing/Claims Processing
• Denial Management
• A/R Follow-Up

Over the upcoming weeks, HMS Healthcare Management Solutions will explore all of these phases and offer insight into understanding the impact each has on the revenue cycle.

HMS Now Offers Long Term Care Billing

HMS Healthcare Management Solutions is excited to announce we are adding long term care billing and operational development to our extensive line of customized services.   We are ready and available to assist your long term care facility with billing and revenue cycle management in addition to the products and services we already provide to home care and hospice agencies.

Let the HMS team of knowledgeable industry experts assist your skilled nursing facility, continuing care community or rehabilitation center with the nuances of long term care medical billing to ensure proper payment.  We’ll apply our reimbursement, clinical, operational, billing, regulatory and compliance knowledge to help your facility succeed in an ever-changing environment.  Contact us today to see how we can help you!