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Healthcare Payment Processing: What You Need to Know

Healthcare Payment Processing: What You Need to Know

As competition in the healthcare industry continues to heat up, providers and billers must look to new options to provide seamless and flexible payment options to retain customers and attract new ones.

Providing a variety of convenient payment options is more important than ever

Patients are frustrated by their healthcare payment options. While they understand the importance of paying their bills, they also want to be able to pay them in a way that is convenient. Many patients would rather pay their bills by credit card rather than cash or check, but they do not always have this option.

Patients have adopted a consumer mindset. From their perspective healthcare transactions should be no different from other transactions. They are more reluctant than ever to put a check in the mail and cross their fingers. In a world of easy online payments and tap-to-pay convenience, healthcare providers need to recognize that the patient financial experience is just as important as the patient care experience.

Most importantly, providing these payment options are not just about giving patients more convenience, but about the bottom line. Embracing new functionality like card-on-file recurring billing and SMS text message payment reminders saves your staff time and increases payment rates.

“We sent out the first SMS payment requests last week, and within several hours had generated 9 payments for a total of over $2,400 back from the patients! The provider is thrilled.”

As the healthcare industry continues to become more competitive, it becomes more critical than ever to create efficiencies wherever possible.

Patient payment data security must be a top priority

In 2016, healthcare organizations suffered a record-breaking number of data breaches. These breaches are not just affecting the health of patients and the financial bottom line of providers – they are also affecting their reputation.

A survey conducted by Ponemon Institute in 2017 revealed that healthcare organizations lost an average of $2.1 million per breach and nearly a third reported losing between $1 million and $10 million per breach. In addition to these costs, there are also significant reputational consequences for healthcare organizations that suffer a data breach. More than half (52%) said they would avoid using a provider following a data breach.

Consumers are concerned about safeguarding their medical information when paying bills; 47% have significant concerns regarding the security of making payments for both medical bills and health plan premiums. They want to take advantage of the consumer protection guarantees that their credit card company offers and a PCI compliant payment processing like EZClaimPay.

Finding the right payment processing partner

Healthcare is more complex than many other industries — a tangle of relationships between patients, healthcare providers, insurers, and unique regulatory requirements such as HIPAA. In this context, there are many providers find that their payment and billing systems do not work well together. Because of these challenges, medical billers and healthcare providers stand to benefit by working closely with their payment processors.

EZClaim set out to build a payment processor from the ground up that addresses these concerns. EZClaimPay helps billers and providers save time and money with functionality like card-on-file recurring billing, ability to offset processing costs with the platform fee functionality, and automatic reconciliation. Plus, increase payment rates with text message reminders and convenient payment portal. Most importantly, because we serve healthcare providers exclusively, we have ensured compliant, industry standard security including PCI compliance.

Streamlining and optimizing payment processing expedites the patient payment process while increasing back-office efficiencies. Healthcare providers that offer seamless, secure, and flexible billing and payment options will retain more customers and continue to attract new ones.


EZClaim is a leading medical billing, scheduling, and payment software provider that combines a best-in-class product with exceptional service and support. For more information, schedule a consultation today, email our experts, or call at 877.650.0904.

Avoiding Common Revenue Cycle Management Mistakes

Avoiding Common Revenue Cycle Management Mistakes

The revenue cycle is a crucial component of a medical practice. Revenue Cycle Management (RCM) is the process of managing patient accounts, interacting with payers, processing claims, and collecting payments related to health care services. As the industry becomes more competitive and physicians are expected to perform more administrative tasks on their own, RCM has become even more important for healthcare providers today than ever before. Unfortunately, many practices still struggle with managing their RCM processes in an efficient manner that allows them to focus on what matters most: patient care. Below is a list of common mistakes made by healthcare providers when it comes to RCM.

Below is an overview of the seven key components of RCM and ways to avoid some of the most common mistakes.

Insurance Verification and Authorization

Insurance verification and authorization is a critical step in the revenue cycle process. If this step fails, all other steps must be repeated. This can result in delays, rework, denials of claims and even patient non-compliance.

  • Verify that the patient is covered by their insurance plan and will not be responsible for additional costs related to their treatment or procedure (co-pay and deductibles).
  • Verify that your provider is in network for each specific procedure with their chosen health plan/policy before completing any work on behalf of the patient.
  • Ensure that all documentation supports your claim(s), including diagnosis codes and clinical notes from EMRs or doctors’ offices detailing what was performed during each visit. These details should align with those found on physical charts signed by both patients and providers alike.
  • Verify eligibility rules as defined by health plans: has a deductible been met? Is there a copay amount due before benefits kick in? In some cases it may be necessary to contact members directly via phone or email asking them these questions so they know exactly how much they owe out-of-pocket. Our partner TriZetto Provider Solutions offers integrated eligibility verification. Automating this due diligence on the front end ensures that you are not left with the cost of having a biller redo this work, or worse, writing of claims.

Patient Registration and Copay Collection

Patient registration and copay collection are important first steps to ensure that your revenue cycle is functioning properly. Patient service, claims submission, remittance processing, and back-end patient collections are all vital components of the revenue cycle management process.

Without these steps in place, you will not be able to complete the full revenue cycle management process.

Service Coding and Charges

The service coding process identifies the type of service or procedure that was performed by your staff. Accurately documenting and coding charges allow you to:

  • Assign appropriate codes for reimbursements from government programs, insurance companies and self-pay patients.
  • Determine the level of reimbursement for each code
  • Avoid fraud and abuse

Billing and Collections

It is critical to collect payments on time, in full and accurately. If you do so consistently, it will be easier to predict future cash flow needs and improve your ability to manage the revenue cycle.

Timely billing is critical because it allows the practice to collect their fees before they become delinquent. Delinquent accounts must be reported to credit agencies which can negatively impact a patient’s ability and willingness to pay for other services at your facility in the future. Late fees should also be considered for patients who are more than 60 days late paying their bill – this can help generate additional revenue by encouraging prompt payment from patients who may otherwise have ignored their bills altogether.

Accuracy is key when collecting payments because inaccurate claims may result in denied reimbursement by Medicare or third-party payers’ due out-of-pocket expenses for patients who were mistakenly overcharged by providers.

Consistency means that providers need regular updates on where each account stands within its cycle; this helps ensure that both patient satisfaction levels remain high and that everyone receives timely access. Efficiency refers not only to how quickly accounts move through management but also how quickly they get paid so providers know exactly how much money they’ll have coming in each month before making subsequent budgeting decisions.

EZClaim provides great tools to help ensure your collections are timely, accurate, and consistent. EZClaim allows you to keep a credit card on file. With approval to charge up to a specified amount, you can make it convenient for your patients and ensure payments are timelier than ever. EZClaimPay also offers email and SMS text message-based reminders, which have proven effective in increasing payment rates.

Denial Management

Denial management is the process of managing patient denials. Denials can be caused by a variety of reasons, including incorrect CPT codes, missing information, or provider errors. Therefore, it’s important to have ready-to-go processes for handling them and getting paid as soon as possible.

When you receive a denial from an insurance company, there are several things you should do immediately:

  • Double-check that all your claims are accurate and complete before submitting them for payment. If there is any ambiguity on the part of the patient or their healthcare provider, this will increase the likelihood that your claim will be denied due to lack of clarity.
  • Request that more specific details regarding the denial be provided. This allows better preparation when submitting future claims related to this patient’s care and ensures there aren’t additional denials for similar reasons.

The revenue cycle is a crucial component of any medical practice. It’s also one of the most challenging aspects of running a practice, especially in today’s increasingly complex environment. This article has highlighted some common mistakes that can be made when managing your revenue cycle and how to avoid them.

4 Strategies to Simplify Patient Payments

4 Strategies to Simplify Patient Payments

With healthcare costs on the rise and an increasing segment of uninsured consumers, the patient payment landscape is changing rapidly. How can medical offices evolve and optimize collections while keeping patient satisfaction high? Thankfully advancing technologies are making it easy to simplify collection processes to increase revenue.

1) Communicate responsibility

How many times have you purchased a good or service without knowing the cost beforehand? Probably not many. Healthcare should not be any different. By providing cost expectations, care providers can give patients the opportunity to not only understand their fiscal responsibility but to also take a proactive, involved approach. Communication allows patients to determine if the value of the service they are receiving is worth the cost. When finances and choices are transparent, patient satisfaction rises.

2) Collect upfront

It’s said that medical providers collect only 25 percent, on average, of available co-pays and deductibles at the time of service. If the patient departs after the initial visit without making a payment, the likelihood of receiving the co-pay drops significantly. Consumers are used to paying for a product at service at the time of use, so why should medical care be different? Capitalize on patients that are willing to pay at the time of service by collecting upfront. Processing payment during the appointment is a step toward helping the patient to be invested in their care, which increases the chance of gaining future payments.

3) Empower patients

We know that patients are taking a more active role in their care and like to be in control of costs. Knowledge is power, and giving patients the information and tools needed is critical to empowering patients to pay. An effective strategy engages the patient early to learn their payment and communication preferences, then proving the proper options.

4) Build awareness

When adding payment options or considering changes to your payment workflow, increasing awareness is key. Be sure to engage your staff and provide the most accurate information on your website and within advertising tools (such as posters in the waiting room). If time and budget allow, conduct a survey to gain patient feedback. A small sampling of users will give insight into the likelihood that patients will adopt new tools and practices. It’s critical to explain the value in an informative, yet simple to understand the way that will resonate with your audience.

Thinking your practice may not have the staff or means to optimize payment processes? Consider tools from TriZetto Provider Solutions that can enable patients to conveniently pay by utilizing a variety of methods, including easy-to-understand statements. Learn how our partnership can help you streamline your workflow, improve efficiencies, and get paid faster.


ABOUT EZCLAIM:
As a medical billing expert, EZClaim can help the medical practice improve its revenues since it is a medical billing and scheduling software company. EZClaim provides a best-in-class product, with correspondingly exceptional service and support. Combined, EZClaim helps improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.

Innovative Enhancements Can Maximize Revenue

Innovative Enhancements Can Maximize Revenue

We see it all the time, a patient visits their doctor’s office to seek treatment and then receives a bill in the mail for their portion of the medical expenses.  When a patient receives the bill, they are often alarmed at the amount that is due and may not have the funding to pay the balance in full.  In a recent study conducted by UCLA, it is estimated that there is $140 billion in medical debt that has been reported on credit reports (VeryWellHealth, 2021).  In fact, this research study found that one in every five consumers was already in collections prior to the COVID-19 pandemic.

As cases of COVID-19 increased in 2020, many consumers feared visiting their doctor’s office that they avoided their routine office visits, and/or lost their employment further impacting a patient’s ability to pay for any medical expenses.  As providers continued to keep their offices open, many providers witnessed a decrease in patient volume while also seeing a reduction in revenue.  According to a recent article published in Medical Economics (2021), 55% of practices were impacted by a decrease in revenue while 60% were impacted by a decrease in overall patient volume.  Combined with the number of patients that were already in medical debt and/or collections, many practices faced a financial crisis as a result of the COVID-19 pandemic.

As the COVID-19 pandemic seemed to become more stable in early 2021, many patients felt comfortable returning to visit their doctor and/or were able to secure employment, providing patients with employer-sponsored insurance coverage. With the current rise of COVID-19 cases increasing again, practices are left with the ongoing challenges of attempting to maximize revenue collection with the risk of history repeating itself and the patient’s inability to pay their medical bills or avoiding their office visits.

Contrary to belief, consumers actually want to pay their medical bills and are seeking more payment options.  According to the 2020 Trends in Healthcare Annual Report, providers and consumers must adapt to a new payment experience in order to enhance how they interact with one another. In addition, more than half of consumers would consider changing their provider for a better payment experience.  One may ask, what constitutes a better payment experience?  Consumers are showing a higher demand for contactless payments and the ability to work with their providers to create a payment plan or auto-payment options. Unfortunately, many providers have not adapted to their consumer’s needs and continue to operate with traditional methods creating dissatisfaction amongst their consumers

How can providers change their operations to facilitate a more consumer-friendly experience for their patients? Front-office staff play a pivotal role when interacting with patients and should be collecting up-to-date contact information to ensure patients are communicated with effectively, have the most recent insurance data to avoid any processing delays, and should collect a patient’s consent ahead of time for new features such as eBills, texting, and payment preferences.  EZ Claim customers can streamline their revenue collection opportunities by partnering with BillFlash for innovative billing opportunities and various payment collection features that consumers highly desire.  While nobody can predict if this recent wave of COVID-19 cases will lead to another quarantine phase or not, it is important for providers and consumers to enhance how they interact with one another to create solutions for healthcare needs.


For more information about automated patient statements and patient payment options, contact EZClaimNexTrust BillFlashGetPaid@BillFlash.com, or call BillFlash at 435.940.9123 (Option 3). For more details about EZClaim’s medical billing software, visit their websitee-mail their support team, or call them at 877.650.0904.


Resources

Hui, K. (2021).  Americans owe $140 billion in medical debt. Here’s how to avoid it.  Very Well Health. Retrieved from https://www.verywellhealth.com/medical-debt-medicaid-study-5194846

InstaMed (2021).  The Trends in Healthcare Payments (11th Annual Report) 2020.  Retrieved from https://www.instamed.com/white-papers/trends-in-healthcare-payments-annual-report/

Luz, M. (2021).  How an effective revenue cycle management strategy can help reduce burnout.  Medical Economics.  Retrieved from https://www.medicaleconomics.com/view/how-an-effective-revenue-cycle-management-strategy-can-help-reduce-burnout

 

How To Improve Medical Billing Collections

How To Improve Medical Billing Collections

With patient payment responsibility increasing each year, medical practices need to be extra diligent in collecting patient payments. This includes sending accounts to collections when necessary. Fortunately, there are steps you can take to make collections easier and more effective—both of which contribute to more revenue for your practice.

Here are three ways to improve your medical billing collections.

1. Be clear about your payment expectations
Make sure patients know when they will be expected to pay, and what payment methods you accept. Collecting copays before each visit is one of the best ways to avoid having accounts sent to collections, so making payment a part of the check-in process is a good idea. Post signs throughout the office to keep bills top of mind for patients. The more reminders you give patients about their payment responsibility, the less you will have to deal with collections.

2. Reach out to patients who have stopped paying
Keep an eye on delinquent accounts. If an account is approaching 30-60 days past due, it’s time to reach out to the patient. Try to have an empathetic conversation to see what you can do to help them pay off their bill. If they are experiencing financial difficulties, offer to adjust the payment terms to something more suitable to their situation. Even if it means you are only collecting part of their payment now, both the practice and the patient will be better off in the long run.

3. Automate what you can
The collections process is slow and cumbersome—if you’re doing everything manually. Software like BillFlash Integrated Collection Services saves your staff a lot of time by handling the manual processing for you. After that, all you need to do is approve which accounts to send to collections, based on the aging and amounts you prefer, and a collections expert will get to work collecting your revenue.

So, visit one of EZClaim’s partners, BillFlash, to learn more about how BillFlash Integrated Collection services can improve your medical billing collections.


ABOUT EZCLAIM:
As a medical billing expert, EZClaim can help the medical practice improve its revenues since it is a medical billing and scheduling software company. EZClaim provides a best-in-class product, with correspondingly exceptional service and support. Combined, EZClaim helps improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.

[ Contribution from the marketing team at BillFlash ]