As a result of increasing patient responsibility, rising healthcare security threats and the growing dependence on digital technology, providers now face more challenges than ever before when it comes to their patient payments process. University of Chicago Medical Center is an academic medical center in Hyde Park on the South Side of Chicago using Epic software. The center needed to collect more because of increasing patient responsibility, but lack of integration and limited online payment capabilities made this process difficult.
Unpaid patient payments are cutting revenue for hospitals across the country, as shown in this recent article about a large hospital chain with lower-than-expected earnings. According to the Trends in Healthcare Payments Annual Report: 2012, the rapid growth of patient responsibility is creating a need for improved patient collection processes for hospitals.
Aspen Valley Hospital, based in Colorado, also saw the need to improve collection processes. Its staff often missed the opportunity during patient visits to collect payments, instead putting the
With the increase in consumer-directed healthcare, patient payments are becoming a more important part of healthcare provider revenue. However, as consumers, patients are accustomed to having a clear understanding of the amount owed prior to making a purchase. Too often in the healthcare industry, patients are clueless about their payment responsibility until they receive a statement. And when patients are confused or uninformed, they are less likely to pay.
Faced with the challenge of collecting more patient payments, Canopy Partners, a
While patient statements are an essential part of the patient payments process, statements can significantly add to the administrative time and costs to collect. When considering administrative improvements, Good Samaritan Hospital realized that many of its inefficiencies existed in the patient statements process. Below is an outline of how Good Samaritan identified issues in its patient statements process and improved these areas by applying statement best practices. As a result, Good Samaritan significantly reduced its costs to collect patient payments
What Are Operating Rules?
Under the Patient Protection and Affordable Care Act (PPACA), the Operating Rules (developed by CAQH CORE) define the guidelines and standards for making electronic healthcare transactions more predictable and consistent, so the industry can be more efficient.
Upcoming mandated Operating Rules include:
Eligibility and Claim Status: Phases I and II
Deadline for payer compliance: January 1, 2013
Why providers should care:
With mandated standards for electronic eligibility transactions, it will be easier for providers to connect to payers to verify patient eligibility
The increase in self-pay patients and rising operational costs are driving healthcare providers to seek out tools and strategies to operate more efficiently and collect more from patients. Depending on your current processes to collect, there are various changes you can make that can have a significant impact on the amount collected and the time and costs spent to collect. Below are three common process issues that billing service Medical Management Corporation of America (MMCOA) faced with its providers, and
The term “administrative efficiency” has been popping up everywhere in the healthcare industry lately. Most provider organizations, from the solo-physician practice to the large health system, should know that they need to make strides to achieve administrative efficiency. However, how can you measure efficiency to tell if you’ve achieved it, or if your administration is still inefficient?
Faced with these questions, Judy Downing, the Billing Manager at Holly Springs Pediatrics, decided to quantify inefficiency in her practice by identifying her greatest
Following the Supreme Court’s ruling on PPACA, the industry can be certain that regulatory mandates, aligned with PPACA, are coming. One of the most prominent changes the industry should prepare for is that approximately 30 million uninsured Americans will begin to receive healthcare coverage in 2014. This means that more patients will receive healthcare services, and hundreds of millions of patient payment transactions will be added to the U.S. healthcare system.
But what can providers do if their patients aren’t paying?
Traditionally, the end-to-end healthcare payments process – from submitting claims to receiving, posting and reconciling payments – has been disjointed and manual, requiring a great deal of paper and leading to errors and delays in payment. However, as providers continue to feel pressure to reduce costs, leveraging integrated technology to streamline these processes is becoming increasingly important. Here’s Eastside Pediatrics’ story and the success they achieved with integrated healthcare payments:
A Series of Problems
Inefficient Claims and Remittance Management Processes
Austintown Pediatrics, a solo pediatrics practice in Austintown, Ohio, has achieved Payment Assurance Level One, reducing its patient bad debt by 50% and cutting payment processing time by 50%.
Here’s Austintown Pediatrics’ story:
The Issues Behind the Business Problems
Lack of Vendor Integration
Austintown Pediatrics leveraged a third-party billing company to manage payer and patient payments; however, the lack of integration with its practice management system led to inefficient processes, reconciliation difficulties and increased patient bad debt.
Lack of Claims and Payment Visibility
Without integration, the