The process of estimating and collecting responsibility from medical office billing services is an arduous task. It is not just about collecting the money directly from patients, but it is also important to ensure the satisfaction of your patients, which will ensure repeated visits as well as positive online reviews. Patients with a precise understanding of the amount they have to pay are more likely to pay their debts, which will increase the amount of money collected and improve practice cash flow.
92% of customers are interested in knowing their financial obligations prior to making an appointment with a physician and 47% are willing to change providers to better understand the cost of services prior to the time of making appointments. With the increase in high-deductible insurance plans and out-of-pocket obligations for patients on the rise, the need to collect on these patients at the time of service is essential for the financial health of your practice.
Medical Billing Services
Assessing the patient’s responsibility prior to adjudication of claims is a difficult task and, as of far, there’s no estimation tool or software that can be used to meet the needs of independent, smaller practices. Small practices are able to accurately estimate the responsibility of patients to limit risks and increase the vital job of enhancing patient collections.
Defining Patient Responsibility
The total responsibility of a patient is the amount a patient owes to their health care provider. It’s the amount of the medical bill the patient has to pay instead of the insurance company. People who have no health insurance are accountable for all medical expenses. If you have a high-deductible healthcare plan (HDHP) must pay for medical expenses until they reach their deductible which is a greater amount than the average.
The majority of patients opt for a high-deductible health insurance plan (HDHP) believing that they won’t require medical attention in the year they are choosing. The majority of the time, they will need to visit their physician more frequently than they originally thought and end up with higher medical bills than they anticipated.
Estimating Patient Responsibility
The reason practices don’t bother taking care to estimate and collect patient responsibility is because they don’t know whether they’re actually permitted to take the estimated responsibility of the patient at the time of service. Patient Responsibility is largely based on the terms of payer contracts and the laws of each state.
As previously mentioned in the context of increasing numbers of patients being covered by High Deductible Healthcare Plans (HDHP) Many payers have become more flexible in accepting coinsurance and deductibles at the point of service based on the amount of responsibility for each patient.
But, it is often required that you list the amount that was paid to the person on the claim when you submit it. Also, they require you to make any refunds due to overpayments within the first day after the overpayment is discovered.
The next issue is whether you should be collecting the entire amount estimated. It is contingent on how you monitor your patient accounts for overpayments and issuing refunds. You should investigate the practice management software that you are using and find out the extent to which it can help the process of collecting payments from patients.
If the patient does not have an enormous deductible that isn’t even close to being fulfilled, you could have to reimburse the patient. This could happen if the claim of another company is processed prior to your claim being approved and there is no amount due for the deductible.
Patients also possess Flexible Spending Accounts (FSA) as well as Health Savings Accounts (HSA) which could be tied to their insurance company and automatically charged to cover services. To get the total expected amount, at the time of service, you need to find the patients who have the FSA or HSA linked with their insurer.
Collecting Patient Responsibly Portion
The most effective method to collect the patient responsibility part is to request permission to place the credit card on file with the authorization for charging up to a specific amount instantly following the adjudication. It is possible to make it the policy of your finances to take an amount equal to the estimate at the moment of service.
A few numbers indicate that on average, practices receive 50 percent (sometimes even less) of patient responsibility once patients have left your office. If you are able to collect more than 50% of the patient’s responsibility prior to service, you’re increasing the rate of collections. The non-collected portion of patient responsibility is increasing all across the country. ensure that your practice is equipped with the right personnel to improve the patient payment and claim process.
Medcare Medical Billing Services
We provide services to over 40 specialties. Medcare Medical Billing Services (MSO) is adept at providing the entire spectrum of services in scope from the management of revenue cycles to ICD-10 test solutions. The primary objective of our company is to help doctors who are looking for billers or coders.