Health plays an important economic role in modern society. Despite widespread access to technological and human resources, the US economy faces significant problems with bankruptcies rising from healthcare debt, healthcare costs and uncompensated care.

Let's be honest, patient statements can be confusing. There's often so much jargon on them that patients don't know when to pay their bill, let alone how to pay it. So, what can you do to simplify statements, and is it even possible to make things easier? We think so. Here's an overview of what's going wrong with patient statements and how to fix them.

Each year hospitals and health clinics lose billions of Medicaid dollars from:

Health insurance is a complex subject, especially when it has a retroactive period attached to it. So what exactly is Medicaid retroactive eligibility, and how does it change? Is there anyone who is automatically eligible for this retroactive coverage? We'll answer these questions, and more, below.

Keeping track of employees is not an easy task. Management often spends a lot of time focusing on what employees are doing, where the "wasted" time is spent, and how to do things faster - making their company lean, mean, and ready for action. No management team sets out to micromanage their employees, but rather to understand where time is spent in order to improve efficiency, productivity, and communication. Emerald has developed a number of processes that are designed to do just that. These three processes have had significant impacts on our organization. 

Paying for medical bills is a straightforward process, right? Although that may be the case when you're a seasoned member of the industry, it isn't an experience that translates to the rest of America. Just 60% of people feel comfortable paying their medical bills. Although the way patients pay their bills has evolved, it hasn't made life any easier for them. In a recent study that examined the consumer payment experience, surprising findings were made. By learning more about them, you can see how Emerald AR Systems could enhance patient communication for you.

Increasingly, people are turning to the internet and social media to find healthcare professionals when they need them. The visibility that sharing online has brought about makes maintaining a good reputation more difficult to attain and maintain. The medical industry has become more competitive, and reputation management is no longer optional for anyone in the industry.

Everyone loves surprises, right? Not when they're surprise out-of-network bills, which are more common than we'd like to think.

Like any business, medical practices need steady cash flow to be successful. By the time a claim goes to the insurance company and back, the patient might not even remember the services they received. Sometimes patients simply don’t consider paying their doctor as a priority. These issues result in the practice not having the money it needs to pay their staff’s salaries, their overhead charges, or for their supplies.

Debt collection is notoriously challenging, especially in the healthcare sector. There are ways to discourage late payments and improve payment rates, with practice, courage, and clear communication necessary to understand the issue and reduce associated problems.

Surprise medical bills are big business. A recent survey suggests 57% of Americans have received a medical bill they expected their insurance to cover.

Surprise medical bills have been the focus of many discussions in Washington over recent months. They refer to services billed when a patient uses out-of-network providers in the following scenarios:

Have you been operating with an understaffed department? Are your 60-120-day buckets getting larger and larger? Do you have way too many manual processes? Were you nodding at any of these questions as you were reading them?  Adding more staff and manual processes are what I characterize as "band-aid" fixes -- great for clean-up projects, but not ideal as permanent solutions to a problem that will continue to rear its ugly head. 

A patient notice is one of the most powerful communication tools in healthcare revenue. Without them, the patient wouldn't know how much to or when to pay. Unfortunately, 57% of patients are confused by their billing statements. The result of their confusion leads to payment delays and an increase patient call volume. 

Let's be real here.  Billing offices don't have time or the resources to manage more calls and they certainly don't want to wait longer to get paid. Emerald's research team decided to tackle the problem. We worked with industry experts to improve the patient statement. We compared multiple notice templates, analyzed patient calls and other concerns related to the statement.  When we finished our analysis, we narrowed our improvements to three main areas.  

We all love free things. But when we think of outsourcing, we typically think of letting go of a process or department; we don’t think of gaining anything. Fortunately, by outsourcing your medical billing and collections services with Emerald A/R Systems, your company can gain more than you ever thought, and for free! That’s right, Emerald A/R’s flat free pricing means all the company’s additional services are free. Let’s look at just a few freebies you can get when you outsource your billing and collections.

INCREASE EMPLOYEE VALUE

On average, the largest companies spend $13 million on training employees, according to a 2017 Training Magazine Report. By allowing an employee, who has mastered a unit, to teach that unit at the next training session, your company can save large amounts of money budgeted for training purposes. 

There’s a goldmine hidden within your billing processes but finding and extracting the extra revenue on your own can take time and resources that few organizations have – unless they have the right partners.

For medical care providers, it is essential to have accurate and up-to-date information for identification purposes -- not only to ensure that the proper treatment is given to a patient but to correct important administrative errors. This article covers issues related to the collection of social security numbers ("SSNs") of patients and prospective patients.

Since Medicaid is a program that is jointly run by the federal and state governments, the billing requirements will vary from state to state. It's important that medical administration personnel in charge of billing understand the rules and protocols, especially where it relates to patient coverage. If a patient is denied Medicaid on the basis of failure to renew benefits, it may still be possible to receive Medicaid coverage through the program's reinstatement process. Note that this is different from situations in which a patient is denied Medicaid on the basis of income or has been otherwise excluded from Medicaid eligibility.

A study of nearly 35,000 online reviews of medical billing office’s nationwide has found that customer service is patients’ chief frustration, not physicians’ medical expertise and clinical skill.

There are so many ways that a Medicaid claim can slip through the cracks of everyday hustle and bustle of a fast-paced clinic. Every year each health center misses millions of dollars in Medicaid payments. In fact, Emerald AR Systems has located over $2 million dollars of missed Medicaid for just 1 rural health center! Imagine what you could do with an extra $2 million dollars? There are so many reasons that these payments are missed and not paid by Medicaid.

The most productive communities are those with a healthy population. That’s why Community Health centers exist: to provide the medical support our communities need to maintain good health. At a state and local level, we’ve all seen the need and the federal government acknowledged the need by creating the Community Health Center Fund in 2010 to pay for the operation and expansion of health centers through the nation. So far, they’ve appropriated close to 3.8 billion dollars. The money helps with the growth of these health centers but it doesn’t solve all their problems.  Joan Quigley, President and CEO for North Hudson Community Action Corp, said “We are always struggling to keep up with funding”. The RAND research group conducted research on FQHC’s. When asked about operational viability, a researcher said “Although many federally qualified health centers have historically provided patient-centered, team-based care, the implementation of other medical-home components, such as expanding access to care after hours and developing data-analytic capabilities, may present substantial challenges in health centers that have limited financial resources or high staff turnover.”

With the national employment rate at 3.7%, it is difficult for organizations to compete for competitive employee candidates. This sets a health center back and the clinic is forced to reevaluate the onboarding process. To do this, many speak with current, competitive employees to understand what attracted them to their organization and gather employee satisfaction suggestions to improve the employee experience Another way to solve the lack of competitive candidates is to create them give your employees educational opportunities. Educational opportunities are a great way to train your employees, the way you like and increase employee retention. It also increases employee value, which saves an FQHC money. Here are a few educational opportunities for every employee within an FQHC.

By Kaylee Riddle and Audrey Cooper 

by: Kaylee Gordon Riddle

The most productive communities are communities with healthy individuals. Community Health has become the nations healthcare provider for poverty level patients. The affordable services allow individuals in our communities to get treatment without debt. Community Health centers also provide

What Federally Qualified Health Centers Need to Know About Form 990

The time for your Federally Qualified Community Health Center [FQHC] to complete form 990 is approaching soon. There aren’t a lot of changes this year so we’ve created

How the billing experience can tarnish a physician’s reputation

Recently, a friend asked me for help. Her husband was involved in an accident and the mounting medical bill management had become overwhelming. She explained that she had tried to

Disputes are increasing every year and resolving them takes time, coordination and money. I have been in the debt collection industry for 12 years. My area of expertise has been in Medical Receivables where I’ve seen the dispute resolution

By: Kaylee Gordon

Inaccurate account information will cause for inaccurate balances to be billed, infuriating patients and hindering the debt collection process; it throws reaching the maximum debt collected out the window. This can be quite the headache for

Two main factors have fueled FQHC health center growth. The first is the investment of federal grant funding to build and support health centers.

Potential new legislation may promote a dramatically change.

It is a sad state of affairs.

Approximately 1 in 2 men and 1 in 3 women has a lifetime risk of developing cancer. The American Cancer Society reports that approximately 1,658,370 new cancer cases are expected to be diagnosed in 2015. Despite the advances in detection and treatment, 1,620 people die of the disease every day in the US.

43 million Americans have medical collection accounts on their credit report.

How is your medical billing department doing? Most would say “okay”. But how can you be sure?

If you fall off the highest point of your life, I will no longer be your net. I will be the concrete.

“You cannot swim for new horizons until you have the courage to lose sight of the shore.”-William Faulkner

October 1, 2015, did it come too soon? A deadline dictated by unwise policymakers? Our opinions differ. But, agree or not, the time has come.

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 past couple of months have been prime territory for bashing ICD 10 and having some fun with the craziness we don’t understand.

A new national survey administered by Emerald A/R Systems www.emeraldar.com shows that the majority (77.3%) of radiology practices are receiving only a 12% rate of recovery from collection agencies working on their behalf. The remainder of the practices are

Cancer is ugly. The effort to get paid doesn’t have to be.

We believe that billing and collections for cancer patients has to be compassionate to be successful. There is no other way. We all know we need to get paid for our services. If there is ever a time in life when those financial transactions need to be handled with great care and careful consideration it is when cancer shares the picture.

In May of 2009, Consumer Reports conducted an investigation into health insurance coverage gaps. They discovered a problem of such enormous proportions that they called it “hazardous” in an article entitled

“This is the song that never ends.

Your collectables are rising,  insurer reimbursements are on the chopping block and ICD-10 is like a tsunami of revenue uncertainty. The last thing you can afford is languishing patient collectibles. So you launch your own collections calls or you hire a collection agency to collect the outstanding debt. STOP right there. Do you know the law regarding outgoing patient calls? Do you know exactly what methods your collection agency is going to employ on your behalf? If not, it could cost you thousands of dollars in fines.

You have done everything in your power to reduce expenses and increase revenue for your practice. You have sharpened your handling of claims; now you file every day and regularly appeal underpaid and rejected claims. Your staff has been