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.”