Automating Patient Collections For Less Pain, More Gain
Patient Collections, The Domino Effect
But, as we know, unmanaged over-the-counter collection of patient balances would lead to growing accounts receivable. These patient balances may include copays and co-insurances not collected at the time of service as well as deductibles and other patient responsibility that are not collected or invoiced to the patient. Also, inconsistent or non-existent patient invoicing would be likely to adversely affect patient balances.
What doesnt get collected at the front desk would then get carried over to the billing department. This would in turn divert the attention of billing teams from more important tasks like claim submissions/resubmissions, follow up with payers on outstanding payments, and appeals of denied claims. Having to send out patient statements would become expensive from the standpoint of time spent and postage.
Making over-the-counter collection even more challenging would be the scenario of fluctuating or changing co-pays, co-insurance, and deductibles across the span of a single patient case. External factors could play a role. For example, there are several changes for Medicare enrollees in 2021. The answer would lie in properly documented front desk, over-the-counter collection processes. Having complete clarity on the amount to collect from each arrived patient at the time of the visit would be beneficial. These processes would need to be implemented in your EMR and practice management system.
Patient Collections, Automate Away
An automated payment plan would go a long way. This would spread the payment amount over time so that the patient would not be hard-pressed while guaranteeing payments through a credit card on file.
Within the span of a single patient case, a patients per visit fee could change quite significantly from one appointment to the next. For example, we might decide to split the deductible over the first few visits. The co-pay may kick in later and then subsequently change to some type of authorization. And then shift again to some form of self-pay. There are several scenarios that could alter what you are expecting to collect on a particular appointment.
Collections management functionality in the EMR/Practice Management system would provide a solution as part of managing patient case information. Essentially, we would control what to collect from one patient visit to the next through a single interface in the software. All insurance and copay amounts in the system would then be automatically updated.
The visit fee could even be the same across all visits and could be updated in one go. We would apply the total deductible and distribute it over a set number of appointments. Additional controls would help for example preventing change to the visit fee for an arrived appointment as that may have already been collected. But we could always override this via the appointment scheduling interface.
The visit fee would then be reflected everywhere there was previously a co-pay value. It would update the face of the appointment, the check-in window, and the collections window. Instead of co-pay, it would be called visit fee that could be updated from the collections management interface, which would represent the single source of truth in the system. A history/summary of patient benefits based on insurance coverage would always be visible on the top of the collections management interface including deductible, co-pays, and co-insurance amounts for the primary and secondary insurances.
End of the day, being able to precisely control visit fees as per each patients unique payment plan would help the cause of over-the-counter collections, making it a smoother and more effective process. Less pain. More gain.