New Workflows for Medical Billing and Collections

As medical premiums have increased, employers are have to select policies that have greater patient responsibility in efforts to keep premiums down. In light of the mentioned, Patient Collections is now more important than ever, since is not just small co-pay, but instead patients now have higher copays, co-insurance (% of bill to be paid by patient) and high deductibles which have changed front office workflows in order to maximize overall collections. According to the MGMA, practices that have not implemented a solid workflow to collect patient’s financial responsibility at time of service, may be leaving up to 30% on the table.

New Collection Workflows

Because of this trend, it’s incredibly important that you put into place a new collection workflow to ensure that your patients are paying what they owe at time of service and in full. It’s no longer just a matter of a patient being a few months late on a ten-dollar copay. You may have been flexible in the past when it came to collecting such fees, but you won’t be able to afford to be so flexible when the amount that’s owed is much more substantial.

As part of the insurance verification process, your staff should be trained to identify patients with high out of pocket responsibility (such as co-insurance or deductible not yet met) in order to advise the patient in advance of such responsibility. Many patients may not even know what they will owe for their appointment, which means that they may not come ready to pay if not previously notified ahead of their appointment date. This will also avoid having to have such uncomfortable conversation in front of other patients while given the patient an opportunity to either come prepared or reschedule their appointment when they are prepared to pay their financial responsibility.

For those that end up with balance after insurance plans process the claim, your front desk should be calling patient to request payment via phone and/or collecting such balance in their next appointment before getting seen. Studies show that high % of patients will ignore statements sent to them at home by physician office. Therefore simply sending patient statements will not result in desired collection results, instead having a solid collection workflow at the office is critical to financial success.

This type of collection workflow requires that your staff is properly trained. Your front desk staff needs to be able to approach and discuss patient’s financial responsibility in a professional and confident manner in order to achieve desired results. Having solid understanding of the insurance verification process AND understanding how to identify/calculate/collect patient co-insurance and deductibles are key to success.

How We Can Help

Here at ProMD, we can help improve your collections workflow in a number of ways. We can perform a practice assessment in order to identify how effective your current collections process is and how it can be improved. You should also consider our medical billing and collections services. These services include charge posting, billing, collection, payment posting, denial appeals, billing and collection reporting and more.

By using our medical billing and collections services, you free up staff and resources to focus on what’s important – providing medical care and running your practice. For more information about our medical billing and collections services, be sure to contact us at ProMD today.

ProMD Medical Billing is happy to help with your billing assessment needs so you can maximize profits and increase patient satisfaction. To learn more about how ProMD can make your practice run like a well-oiled machine, call 866-960-9558 or fill out our online form to request a billing assessment.

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