Aug 15, 2022 | MedCycle Solutions, Partner
By Ann Knutson, CPC-A
The healthcare revenue cycle includes all administrative and clinical functions that involve capturing, managing, and collecting the provider’s/facilities revenue. The cycle includes three distinct parts of the practice/facility that’s referred to as the front-end, middle, and back end. Unfortunately, most of the time there is little coordination between the three areas which can lead to more claim denials and lost revenue for the practice/facility. Therefore, adding a revenue integrity team to your practice/facility dramatically improves operational efficiency, compliance measures, and reimbursement rates. Members of the team must have extensive knowledge of and be familiar with the complete healthcare revenue cycle.
In order to foster collaboration between all three areas of a practice/facility that affect the revenue cycle, specific training needs to be implemented for staff, along with coding and documentation education for providers.
Specific staff training includes:
- Keeping up to date on billing requirements, such as coding guidelines, billing regulations, and insurance payer policies.
- Reimbursement updates, such as data showing rate of reimbursement vs. denials/rejections.
- Key performance indicators, such as data regarding common billing or coding errors leading to claim denials and rejections.
- Job expectations, such as all billing employees must know every aspect and function of their job in detail.
Provider education involves:
- Chart reviews to verify proper documentation.
- Quarterly meetings regarding coding guidelines, payer rules, and the importance of medical necessity.
Furthermore, creating templates and tip sheets for billers, coders, and providers improves operational efficiencies, clean claim submission, and proper provider documentation. It also decreases claim denials and puts everyone in the practice/facility on the same page.
In addition, the collaboration between coders and the accounts receivable team is crucial to improving reimbursement rates, the outcome of claim appeals, and compliance with regulations. It can also help to reduce the number of claim denials and rejections. Plus, medical coders are able to share their expertise regarding regulations and proper coding with the Accounts Receivable (AR) team members. This helps the AR team with reconciling claim rejections and denials along with properly submitting appeals. On the other hand, the AR team can inform coders of the current codes or coding combinations that are being rejected or denied by payers. With this vital information, coders can make the required coding and billing changes as they enter the charges and submit the claims. This can greatly improve the rate of clean claims submission. (AAPC, 2021)
Therefore, it’s in the best interest of a practice/facility to implement a revenue cycle management team that is familiar with the entire revenue cycle, fosters collaboration between all areas of the practice/facility and providers, and maintains open communication between all departments in order to maximize revenue cycle efficiency and reimbursement. For assistance with maximizing your revenue cycle efficiency, please contact us at MedCycle Solutions.
For more information about maximizing revenue cycle efficiency, please visit www.aapc.com.
Ann Knutson, CPC-A is an Accounts Receivable Specialist at MedCycle Solutions, which provides Revenue Cycle Management, Credentialing, Outsourced Coding, and Consulting Services to a number of healthcare providers in a variety of specialties. To find out more about MedCycle Solutions services please visit www.MedCycleSolutions.com. Â
Sep 23, 2021 | BillFlash, Partner
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 EZClaim, NexTrust BillFlash, GetPaid@BillFlash.com, or call BillFlash at 435.940.9123 (Option 3). For more details about EZClaim’s medical billing software, visit their website, e-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
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Jul 14, 2021 | BillFlash, Partner
There is no surprise that the cost of healthcare continues to rise creating financial hardships not only for patients but for physicians as well. While the COVID-19 pandemic severely impacted how patients interacted with their physician’s office, it is important to understand that patients want to be financially responsible for their medical bills and have preferences on communication methods to increase revenue.
In order to improve the overall patient experience and collection of revenue, it is important for physician offices to truly understand the demographics of their patients and the differences amongst their generational behaviors. Using a one-size-fits-all approach to communicate with patients is an outdated method and oftentimes leads to patient frustration, lack of engagement, poor retention, and missed opportunities to enhance revenue collection.
In a recent article published last month, physicians must adapt to the patient’s digital experience in order to enhance receiving payments for medical bills (Healthleaders, 2021). Patients desire modern payment options such as a payment portal, mobile ability, texting capabilities, and/or scanning a QR code. In addition, 76% of healthcare consumers desired a contactless method that allowed them to view their statements online and make payments without the need to visit the doctor’s office. According to (Healthleaders, 2021), the number one payment option patients desire is contactless debit and credit card options. In addition, patients desire payment options to help them manage their medical expenses such as payment plans and/or auto-pay methods.
As a medical billing expert, EZClaim can help medical practices improve their revenue through their billing and scheduling software in conjunction with BillFlash, which provides contactless and modernized communication methods that patients highly desire. Let EZClaim and BillFlash enhance the options to modernize your medical billing and communication systems.
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.
Apr 5, 2021 | Medical Billing Software Blog, Waystar
For many providers, medical claim denials are one of the single biggest drains on revenue. When you consider that working just one denial costs about $25, knowing why claims are being denied and how to prevent them in the future isn’t a luxury—it’s a necessity.
Automation and advanced analytics can take much of the burden off your billing team by helping you identify potential denial triggers, adapt to constantly changing payer guidelines, and uncover actionable trends in your claim data.
Waystar’s Denials by the Numbers:
- 5-10% average denial rate amount physician practices
- 90% of denials are preventable
- 76% of providers say denials are their biggest RCM challenge
[ Note: View or download Waystar’s “Defeat Denials with Data” white paper here ]
Waystar, a partner of EZClaim, integrates easily with its medical billing software, creating a seamless exchange of claim, remit, and eligibility information. To learn more about defeating medical claim denials, or to add Waystar as your clearinghouse, visit this page.
ABOUT EZCLAIM:
EZClaim is a medical billing and scheduling software company that provides a best-in-class product, with correspondingly exceptional service and support. Combined, they help improve medical billing revenues. To learn more, visit EZClaim’s website, e-mail them, or call them today at 877.650.0904.
[ Article and white paper contributed by Waystar ]
Apr 5, 2021 | BillFlash, collections, Credit Card Processing, Denied Claims
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 ]
