Medical practices have struggled with the decision to outsource self-pay receivables for decades. A recent HFMA study discussed a myriad of choices available and each choice presented a compromise of one trade off or another.

The new comprehensive self-pay programs feature advanced technology, custom designed programs, new patient friendly service features, menu based pricing and agreements that can be canceled in 30 days.

Making the decision today is far less daunting than 10 years ago. As a medical business manager you should never have to “trade off” and the decision should be a priority.

In today’s “Age of Consumerism” the patients have the power. They simply will not settle for sub-standard billing practices. Most billing offices cannot not keep up with the demand for information and explanation when it comes to their portion of the medical bill. The number one patient complaint in a hospital is not with the doctors, service or wait times; it is with the billing practice itself. If this is the difference between patient retention or not, the decision is obvious; fix the problem.

Like your billing software, you are forced to pay for the total package. If you could list exactly what you need and the software is programmable to only fit those needs you would not only receive more for your money but your training times would be greatly reduced. So let’s examine your billing office step by step.

Statements:

Are you forced to accept the statements your system has previously set up? Shouldn’t these statements be customized for your facility’s needs? The first contact with a patient is the most important opportunity to present you bill. It must be patient friendly, itemized and clearly detail the patients balance and why they owe this money. Doing so will eliminate patient confusion and encourage prompt pay. The statement must provide each patient with payment options, not just a “balance due”. It must provide answer to their questions. And let’s not forget our Spanish speaking population. The statement should be customized to recognize our changing patient demographics. How are you working the mail returns? What if you had the correct addresses to begin with?

Phone Calls:

Your office policy may be to place an outbound call to facilitate payment but more than likely the option is to take incoming calls and little time is spent proactively calling patients to assure they received a bill and to ask if they have any questions. The average patient account rep takes 12 inbound calls a day averaging 15 minutes per call. This equates to three hours of your reps time doing nothing more than explaining what should have been obvious on the first contact. It is not litigiously wise for you to be making these calls without the knowledge of new laws of contact. Privacy related lawsuits are exploding in the United States and more are to come. Every phone agent must have the knowledge of patients’ rights as related to what can and cannot be discussed and with whom that information can be released. Think for a moment how effective a follow up phone call would be if you were only asking the patient if they received the statement and if they have any questions? You could eliminate those roadblocks and advise your patient on the different methods to pay the bill. Again, let’s not forget the Spanish population. Are your reps bilingual?

Post Medicaid Eligibility:

Of course you check eligibility upon enrollment, but what happens after that? In today’s billing environment patients fall in and out of coverage like the weather changes. You must have the automation available for continual cross examination of your patient payer base.

Segmentation:

Does your billing office scan for bankruptcies, deceased patients and insured patients? When your billing practice is continually sending statements and working accounts that should never be in the cycle is costing your facility a fortune.

Payments:

How do you post the payments for self-pay accounts? Is someone still opening mail? Are you manually posting payments? Do you have online options or a phone IVR for patient convenience? What if you could automate the payment process? How much time would you save?

There are so many functions to cover in a billing office and these are just a few. Many companies like Emerald have emerged with new solutions. To keep your cost down while improving patient satisfaction, allow you to maintain control, Emerald has presented a structure to help a healthcare provider benefit financially as much as the insured patient.

The solution is simple: Pay us only for the services you need.

There is no reason to enter into a long term solution filled with bells and whistles for services you may not use or need. Emerald service can be scaled easily without compromising patient satisfaction for commissions. While Emerald still offers a full service contingency fee Extended Business Office that takes your self-pay from day one, each and every service is also available ala carte.

Please allow an Emerald representative to show you how this pricing offering can enhance your internal billing operation while keeping your costs at a minimum. Send me a LinkedIn invite or an e-mail to set up a time for discussion.

By Tom Jensen, Emerald A/R Systems

tjensen@emeraldar.com