Self-Pay Revenue Management

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Disputing Medical Debt

June 6, 2018 - 11:38 PM

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 landscape change drastically.

Reason for Medical Disputes

The Medical field has a complex billing process that involves many different individuals and entities to resolve a patient account. This process is confusing to patients. A radiology medical bill from a billing service or debt collection agency may include several charges they never expected for physicians they forgot treated them. In fact, they may have seen a physician while heavily medicated and completely forgot the visit occurred. To make it even more confusing, the bill may be different from the Explanation of benefits they received from their insurance company. This confusion leads to mistrust and mistrust leads to disputes.

Medical Dispute Resolution Tips

The best way to resolve disputes is to create a well-defined process. This type of process will need to be designed to meet industry compliance standards, a well-documented procedure that’s evaluated monthly to ensure standards are being met.

Here are some quick tips that helped me when creating a dispute process.

  1.  Look for a way to automate some of your procedural steps. This will help save you time and create internal efficiencies.
  2. If you have a website, create a dispute page and direct your patients/consumers to submit their disputes there. This can cut down your dispute processing time and provides a more modern communication channel.
  3. Last, use a resource outside of the dispute department to evaluate your dispute process. This should be an individual who’s unbiased, thorough and committed to maintaining compliance within your organization.

Dispute requirements will continue to change but creating well-defined processes now, will make it easier to manage disputes, prevent unwanted lawsuits and provide patients and consumers with the information they need to resolve their bill.

Written by Acooper32

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