Health Technology, AI
Article | July 18, 2023
While many United States healthcare providers are returning to their in-person offices, many others are digging in to offer hybrid telehealth or exclusive telehealth practices moving forward. Understanding the future of telehealth reimbursement is then a pivotal issue. As a hub for telehealth consultants and trainers, the Telebehavioral Health Institute (TBHI) is receiving daily requests for assistance from behavioral health groups and independent practitioners seeking to position themselves for telehealth expansion optimally.
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Health Technology
Article | September 12, 2023
Managing accounts receivable (A/R) in private practice is a constant battle for physicians. Though most understand that lowering their A/R is critical for improving their practices’ efficiency and profitability, physicians often do not know how to address issues like lengthy collection periods and insurance claim denials.
It can be complex to manage A/R, as doing so involves various parties, including insurance carriers, the patient, the front office and billing staff, and the provider. All must work together to achieve a clean claims rate and avoid denials.
The best way to improve medical billing A/R is to reduce claim denials and speed up the patient collections process. In addition, you’ll need to ensure that patients and staff are filling out paperwork correctly and submitting claims on time. Other areas to manage are the follow-ups to correct errors and past-due accounts.
Accounts receivable is a collaborative effort
Each member of the practice staff plays an integral role in reducing claims denial rates. Take an all-hands-on-deck approach in order to identify issues and develop solutions. Start by making every team member privy to the A/R management process. This will ensure everyone is on the same page and involved. It will also help to increase efficiency, avoid redundancies, and eliminate mistakes that could waste time or profitability.
The front office staff is the front line of A/R. They are the first to verify and update patients’ insurance and personal details like address and contact information. They must also ensure that patients sign certain documents, like financial policies.
Providers are the next line of A/R. Providers select current procedural terminology (CPT) codes, and must be mindful of tedious details such as bundling correctly in order to ensure that claims are approved. A conscientious provider should not only select appropriate billing codes but also double-check the patient information that the front office staff provide.
The billing office is a final line of defense and should triple check that the patient’s information and the CPT codes are correct. Billing office staff are also responsible for ensuring the claims are submitted on time and that duplicates are not submitted.
Establish financial policies
Every practice needs clearly defined financial policies around patients or clients. Having these policies in place helps to clarify financial details and creates workflows and processes for staff to follow. Here are a few elements to consider:
State whether the practice will accept personal checks and, if so, what charges or actions are in place for bounced checks. Consider implementing technologies that convert paper checks to electronic transactions and verify them before patients leave the office.
Include a financial responsibilities section with information about who is responsible for the claim(s) if a patient’s insurance carrier partially or fully denies their claim.
Define the debt collection process. Patients should quickly know how long they have to pay their bills and at what point you may sell their debt to a third-party debt collectors agency.
Medical records can be copious, and practices often need to make physical copies of them. Consider implementing a policy that covers a pay-per-page cost associated with medical records.
Automate patient statements and payments
Offer different payment options for patients by implementing technologies and creative solutions that make it easier for them to pay their bills. Look for solutions that reduce manual work and provide reporting that tracks efficacy across delivery modes. Here are a few approaches to consider:
Automate sending statements via text message or email to help improve the rate of online payments.
Add QR codes to online and paper statements to help patients quickly access payment portals.
Offer payment plans, especially with low to no interest, to make it easier for patients to pay down balances.
Establish a written collections process
Not collecting patient payments at the time of service is the biggest challenge to patient collections. Establishing a written collections process can help to alleviate that pain point and clarify the practice’s policies and procedures so that patients can understand them more clearly and easily. Here are some guidelines to follow when creating your policies:
Include when, how, and how often bills are sent.
Provide information on payment plans and assistance programs, if available.
Explain the different available payment options and whether patients can pay over the phone, online through a payment portal, etc.
Clarify which extraordinary collection actions may be used, including selling the debt or taking legal action.
One of the most important processes to develop with collections is to respond to patients’ behavior. Communication should not be a one-size-fits-all approach. Patients expect personalization, and reaching out to them based on their preferred means of communication leads to optimal results.
Perseverance is vital when it comes to collections. By establishing clear policies and implementing integrated technology throughout your processes, you can improve the patient experience by eliminating confusion while streamlining workflow to reduce the administrative burden on billing and administrative staff.
Although implementing these steps can help your practice lower your accounts receivables, sometimes choosing to outsource to a medical billing company can help you save time, money, and resources. Medical billing companies can provide medical practices with specialized expertise, technology, and infrastructure to efficiently manage the revenue cycle and ensure timely payments. Outsourcing medical billing can also free up staff time and resources, allowing healthcare providers to focus on patient care and other essential aspects of running their practice. Whether you choose to outsource or to keep your medical billing in-house, these tips will help you to reduce your costs and increase your revenue.
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Health Technology, Digital Healthcare
Article | September 7, 2023
Before we discuss the importance of telehealth and how it is changing the nursing industry in general, it is important to understand what telehealth is all about. With the advent of new-age technologies and their impact on the fast-paced, growing population, medical health is an essential department that requires special attention. One’s health is of utmost importance, and to enhance the medical facilities, we as responsible citizens and experts in this particular field must come up with novel and quick solutions to provide optimum precaution and cure. Hence, one of such technological achievements is telecommunication,s and by utilizing such a useful resource, health-related services too can be offered. Telehealth promotes the distribution of various services related to medical health through electronic devices and telecommunication technologies. What can one possibly do if he or she lives in a different country and is pushed to an emergency situation where he requires medical advice from a physician who lives in another corner of the world? Of course, through telecommunication devices, the whole process of exchanging information becomes smoother and easier. Several health-related services such as medical advice, medical care, monitoring, education, remote admissions, and intervention can be extended to a long-distance patient with the help of telehealth facilities. Hence, the contemporary picture of health and medicine has been radically improved with the introduction of these electronic telecommunication systems.
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Digital Healthcare
Article | February 19, 2022
As competition for patients intensifies, more hospitals and health systems are embracing a consolidated, single-bill approach for services rendered. Creating a single bill for the patient’s portion of inpatient or outpatient services can help eliminate confusion and reduce the ill will that frequently results when patients receive multiple invoices for a single care event. Yet incorporating anesthesia charges into a consolidated invoice is often problematic due to the unique nature of the anesthesia billing compliance.
Anesthesia Billing Service Hurdles
A few weeks ago, I met with the CEO of a 300-bed hospital. We discussed anesthesia billing, and he explained that his hospital traditionally outsourced this portion of its billing due to the more complex nature of anesthesia coding and the need to collect anesthesia minutes for billing. Unlike most inpatient services, anesthesia charges are not directly derived from CPT codes but instead utilize minutes and modifiers unique to the specialty.
That means coders must use a CPT crosswalk to account for ASA codes, base and time units, emergency- and physical-status monitors, split anesthesia units reflecting CRNA involvement, and other specialty-specific nuances. Most coders and hospital billing staff are not trained in these complexities, and hiring and retaining capable staff in today’s competitive market can be difficult. Moreover, many billing platforms are simply not equipped to incorporate all the variables necessary to produce an accurate anesthesia bill.
As a result, producing a consolidated patient bill that includes anesthesia is tricky. Yet leaving anesthesia off a single bill can undercut its value since, after facility and surgical charges, anesthesia often is one of the largest cost items patients incur. Fortunately, we at Change Healthcare know how to roll anesthesia charges into existing hospital billing systems to produce an accurate and timely single patient bill.
Helping to Reduce Costs
The benefits of consolidated billing extend beyond an improved patient experience. Producing just one bill reduces costs and repetition at both the front and back end of the revenue cycle management process. It can also ease staff burden when collecting on self-pay accounts, since there’s only one bill per patient. Finally, consolidated bills can help increase revenue by simplifying collections when patients present for follow-up care.
Here’s an example: When the patient comes back for post-surgery physical therapy, a hospital employee at the registration desk can remind them that they still owe $150 for anesthesia and ask if they’d like to take care of that now. In my experience, patients usually hand over their credit card and settle their bill on the spot when asked at the time of care about a balance due.
System-Agnostic Billing Across Hospital Platforms
Change Healthcare has a long history of providing full-service, outsourced anesthesia-billing services to hospital and health-system clients. Unlike most other billing vendors, we’ve developed what we call a system-agnostic approach. That means we’ll provide billing services on our proprietary system or on the hospital’s existing billing platform, regardless of type, to generate accurate anesthesia-billing results.
In practical terms, we’ll function as part of your billing team and use the same system your coders and billing staff rely on to generate anesthesia charges that can be included in a single patient bill.
System-agnostic billing also allows us to provide clients with custom anesthesia reporting that wouldn’t otherwise be available with an outsourced billing solution. This helps clients gain far greater visibility and insight into anesthesia-billing charges. And by incorporating our anesthesia coding and billing capabilities into your existing billing system, you’ll be spreading the platform’s fixed costs across a greater number of departments.
The bottom line? It’s not a heavy lift for us to virtually embed our trained anesthesia coders and billing professionals into your system. Our specialists will review your existing platform and provide, at no obligation, a return-on-investment analysis that can help you determine whether outsourcing anesthesia billing to capture claims on a single hospital bill makes sense for you.
We expect the answer will be yes. Not only will you enjoy greater system efficiencies, but you’ll be in a position to produce a single bill that truly reflects the entire episode of care.
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