“Health Care PRICE Transparency Act” Proposed

Health Care PRICE Transparency ActA group of senators introduced the “Health Care PRICE Transparency Act in a move to empower patients to lower their healthcare costs.

On a basic level, the Act will require all medical facilities to post payer-negotiated rates for all shoppable services, so the patient can find the most inexpensive way to take care of their medical needs. This legislation will give Americans the chance to see the actual costs of their healthcare visits, which in theory, will increase competition and lower healthcare costs for everyone.  

The added transparency of the Act will bring more accountability and competition to the healthcare industry, and gives American’s more control over their healthcare costs. However, if you are a medical practice, a hospital, or a member of the medical billing community, you need to know how you can best respond.

 

• “What is this procedure going to cost?”: There is going to be mounting pressure on practitioners, medical billers, and hospitals to have answers for the cost of procedures.  Jeff Leibach, a director with Guidehouse’s healthcare strategic solutions team, says that “regardless of the legal fate of the final rule, hospitals need to be prepared for more price transparency in the future.” So, to get in front of this—and help you compete against your competitors—you should be prepared with both what it will cost for individual services and procedures, as well as, a ‘value statement’ on why it will cost what you are charging.

Prepare to Comply or Cover the Costs: As it stands now, the legislation is moving towards technology assisting with the billing transparency. This will aid the patients to better understand the cost of services. This is a ‘clarion call’ for you to begin preparing for this reality or you will struggle with being fined and potentially publicly shamed in publications for being offenders. We recommend starting to comply NOW before the deadline ‘sneaks up’ on you.

Use It To Improve: Currently, healthcare practices are, in many cases, already working at capacity. The added effort of defining cost and selling procedures are enough to make some healthcare facilities put this off until it is too late. Yet, while many may be considering accepting the fines and fees associated with non-compliance, we advise using this as an opportunity to improve—to better establish your medical practice’s services, and promote your ability to be proactive to change. Getting ahead of the coming ‘wave’ of consumer expectations of healthcare will be a benefit.

Seek Out Vendors That Can Assist: The changes that are coming for individual practices and healthcare providers can be overwhelming, and potentially it might just be more than what an IT team or private practice can handle. Forward-thinking billing departments should be investing in software vendors that can help fill that gapEZClaim is a medical billing software company that partners with Trizetto to provide a tool called, Patient Responsibility Estimation (PRE). This tool assists in clarifying costs to consumers by providing a cheap and fast way for them to pay for out-of-pocket costs. [ Click here to learn more about how EZClaim can help you ].

 

It is clear that the expectations of consumers are changing, and the wave of medical transparency is on its way.  Accepting it, preparing for it, and using vendor software to help overcome it, can be the difference of your practice avoiding fines and fees. For those forward-thinking and proactive practices who want to learn about how EZClaim can help, e-mail one of their sales representatives, go to their website for more details, or download a FREE 30-day trial today!

Getting Paid for Telehealth Visits

Telemedicine was already growing in popularity prior to the onset of the Coronavirus pandemic. So, as the adoption rate increases, EZClaim clients may have questions about sending telemedicine charges and getting paid for Telehealth visits.

Telehealth challenges can range from issues with technology to getting paid. With Telehealth becoming the norm for many doctor-patient visits, it is important to have a thoughtful approach in place regarding collecting patient payments. To stay in business, you have to get paid for the work you are doing. So, establishing a process for Telehealth consultations is vital to your business, and it should be a top priority to build a successful program from beginning to end.

The answers to the following questions will help set the baseline for how to collect patient payments for
Telehealth visits:

  • What is my process for charging for copays?
  • How and when do I collect outstanding balances?

For example, if you collect a payment before an in-person visit, you should collect a payment before a Telehealth visit, too. There is no need to re-create your process completely. Just change what is needed to match your current in-office routine.

Sending Charges Before a Telehealth Visit

A simple way to send pre-visit charges to patients is to provide them with a link that takes them directly to the payment site. EZClaim’s medical billing solution is integrated with BillFlash LinkPay, which enables customers to provide a payment for the upcoming visit. So, before the Telehealth session begins, the practice simply sends a link to their patient via an e-mail or text, making the appointment confirmation and the payment processing part of the check-in process. After the payment transaction is complete, it will immediately show up on the practice’s BillFlash report. LinkPay is designed to be easy to use, and doesn’t require patients to remember a login or a chart number.

Here’s how EZClaim enables the process through BillFlash:

  1. Prior to Telehealth visit, the patient is sent a link to pay through LinkPay, and another link to join the Telehealth call
  2. Patient pays the required amount through LinkPay, which is immediately confirmed and processed
  3. Patient joins the Telehealth session
  4. Results and follow-up are completed electronically
  5. Insurance billing is completed
  6. Patient receives paper statement or eBill notification for any remaining balance
  7. Patient is directed to pay the remaining balance online at MyProviderLink.com

Automate What Can Be Automated

With so many changes taking place in healthcare, a great way to help protect the financial stability of your practice is to automate what can be automated. This saves your staff time, and decreases your cost of doing business.

One way to do this is to set up automatic payment plans for patients, particularly for those who have been hit hard by the economic impact of COVID-19. A payment plan is a good way of keeping the revenue flowing in, and it shows your patients that your are compassionate and willing to help them through these unprecedented times.

BillFlash also securely stores payment information, so patients will not need to re-enter their information every time they pay a new bill.

As you continue to adjust to Telehealth going forward, BillFlash can simplify patient billing and payments significantly and help getting paid for Telehealth visits.

So, for a LIMITED TIME (during May 2020), EZClaim customers can try BillFlash statement and eBill services for FREE for 30 days. Click on this link for more details about BillFlash or try it out for the next month.

For additional information, call BillFlash at 435-940-9123, or contact EZclaim’s support team at 877.650.0904 or support@ezclaim.com.

[Contributed by James Easley VP, Marketing NexTrust Inc.]