In an era when the patient is responsible for more of a hospital’s revenue, operating revenue cycle and patient experience in separate silos doesn’t make sense. In his latest installment for the American Journal of Managed Care, our CTO and Co-Founder Chris Seib offers readers his take as to why the patient experience needs to play a bigger role in a healthcare organization’s payment and billing process.
Many healthcare providers are concerned about the impact to their businesses that will result under PPACA. Much of this concern is due to the additional 20 to 30 million uninsured Americans that will begin to receive new healthcare coverage in 2014. With more patients eligible to receive healthcare services, and hundreds of millions of patient payments transactions being added to the U.S. healthcare system, the difficulties providers face with patient collections is becoming a high priority issue.
Shifting the focus to
The rise of consumerism in healthcare is driving providers to evaluate their tactics to collect healthcare payments. While providers previously relied almost exclusively on payer payments for their revenue, patient responsibility is increasing as a portion of provider revenue. In order to collect more from patients and reduce administrative costs, providers need to offer more convenient, consumer-friendly payment options, such as online patient payments.
According to the 2011 Trends in Healthcare Payments Annual Report, online patient payments have tripled since 2009.
The latest trends in the healthcare industry — the rise in consumerism, increase of costs and new regulatory mandates — are driving change in the healthcare payments process. As health insurance premiums continue to grow, employers are switching to lower cost, high-deductible plans, resulting in an overall decrease in payer payments and, consequently, an increase in patient payments. As a percentage of provider revenue, in 2009, payer payments represented 79% of the allowed amount, while patient payments represented 21%. In
In the healthcare industry, the clearinghouse you work with has a huge impact on your business. The more efficiently your clearinghouse processes and returns your information, the faster you will get paid, and the more payments you will collect.
To gain insight into what providers need from a clearinghouse, we interviewed Kevin Milam, owner of The Billing Center, which does billing, consulting and accrediting for providers across several states. We came up with five essential qualities to look for when researching
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