3 Reasons Why It’s Better to Outsource Your Business Office Locally

Posted on April 24, 2013 by admin

To run an efficient office, business process outsourcing is a must for many hospitals and medical practices. It allows providers and hospital administrators to make better use of their resources and gain access to experts in specific fields. Not all healthcare organizations know that they have a choice between partnering with a local revenue cycle management company and contracting services overseas. Both types of outsourcing have their respective benefits, but when it comes to running a healthcare business, working with a local company is the way to go.

Here are a few reasons why outsourcing locally is the best choice for hospitals and providers:

1. Protect your brand and reputation.

A locally owned and operated company has a sense of “homeland.” They care about the reputation that you have established for your brand. Their employees, who personally know your company and have a greater tie to it than workers abroad, feel more accountable and committed to delivering positive results.

It is also important to think about the people your outsourcing partner is going to contact: your patients. Any party that contacts patients on your behalf is an extension of your company, and it is important for the sake of protecting your brand that they share your organization’s vision and values. Working with a local business process outsourcing company or third-party medical collection agency will offer patients a greater sense of security and will give you peace of mind.

2. Maintain effective communication with patients.

When you outsource overseas, language differences and cultural barriers come into play. This can lead to misunderstandings that affect your bottom line. However, this is not a problem with domestic outsourcing. A local revenue cycle management business will be able to communicate more effectively with patients than one whose representatives are located halfway across the globe. This is due to the fact that a local representative can talk with patients the same way you would and can better understand local references, which might be affecting a patient’s ability to pay. Listening skills and communication can go a long way when it comes to billing and collections, which allows reps to become more successful at collecting payment from patients.

3. Ensure the privacy of patient data.

Protecting patients’ personal and confidential data is extremely important when it comes to healthcare, and the fact is, the laws that govern privacy are all locally based. This is why it is important to work with a local business process outsourcing company or third-party medical collection agency that is subject to the same laws you are. Not only will this give you more control over what happens to your data, but it will give patients a greater sense of security knowing that the people that they are talking to are bound by domestic laws.

Learn more about the keys, benefits and stumbling blocks to good listening skills.

This information is not to be construed as legal advice. Legal advice must be tailored to the specific circumstances of each case. Although we attempt to provide up-to-date information, laws and regulations often change. We make no claims, promises, or guarantees about the accuracy or completeness of this document. For legal advice, please consult an attorney.

Three Insurance Billing Suggestions to Increase Your Practice’s Revenue

Posted on February 13, 2013 by admin

Every year, your practice can lose hundreds to thousands of dollars by not efficiently managing insurance claims and denials. By reviewing some basic insurance billing follow up, medical collections and denial management procedures, your practice can reach its maximum revenue.

1. Regularly ask patients for insurance cards and make a copy to keep on file. Though it may seem somewhat tedious to request insurance cards from repeating patients, doing so ensures that your billing department has updated demographic information in order to have clean claims and denials on the first submission. Your front desk staff should make copies of the front and back of the card and attach it to the patient’s chart. This is also an opportune time to request and make a copy of the patient’s driver’s license or photo ID so that you have all information for your records.

If a patient does not have their insurance card with them and guarantees that their information has not changed, ask them to fax a copy of it to you anyway. Insurance carriers often change ID numbers or prefixes, despite coverage not having changed – and patients might not be aware of these small modifications.

2. Regularly work claims and denials or utilize a business process outsourcing company. The best way to ensure that claims are filed on time is to submit them as close to the service date as possible. Using an insurance follow up and denial management company is beneficial in helping to identify any denied claims so that corrected claims can be resubmitted in the most timely and efficient way possible. Insurance follow up and denial management companies also have greater capabilities to follow up with your payers to identify, address, and rectify any insurance problems so that your practice is able to work more productively while still increasing revenue.

If your practice has the ability to handle claims on its own within the billing department, it is critical to be aware of the filing deadlines for each of the different payers with which you work. Most payers have a timely filing limit, which can be as little as 30 days from the date of service. If you miss that date, despite your best revenue cycle management efforts, your practice might never get reimbursed for the services provided.

3. Make billing the only priority for your billing department. This may seem like an obvious statement; however, billers – especially in smaller practices – often have other responsibilities that prevent them from dedicating enough time to billing and medical collections. Although it may be more difficult for smaller healthcare organizations to designate staff and resources, your practice can still take extra measures in administrative and clerical functions to ensure that your providers are paid all money owed by patients and their insurance companies. Despite the size of your practice, allowing billers the time to ensure charges are accurate before posting them can have a significant increase on your cash flow and the greatest reward: higher collections.

Three Common Causes of Claim Denials and How to Avoid Them

Posted on January 7, 2013 by admin

Claim denials can lead to significant cash flow loss for any medical organization, offsetting gains in your healthcare revenue cycle. Luckily, healthcare organizations can avoid the majority of denials by performing careful claims processing and error prevention tactics. Organizations that effectively implement these practices join the ranks of the most successfully-performing medical groups, which average a claims denial rate of just four percent, according to the Medical Group Management Association’s (MGMA) 2011 “Performance and Practices of Successful Medical Groups” report.

In order for a healthcare organization to submit cleaner claims, reduce write-offs and increase revenue, it is important to understand some of the common causes of denials and how to avoid them. Below are three reasons why insurance claims often get denied, and how your practice can prevent that from happening:

1. Information is missing. Leaving out even one crucial piece of information, such as date of service or patient subscriber number, can cause a claim denial and create a delay in payment. Before submitting any claim forms, be sure to check that all required areas are filled in. You can also provide your billing representatives with a list of commonly missed fields to double-check before transmitting the claim to the payer.

2. Codes are omitted or assigned incorrectly. In order for a medical claim to process correctly, it is necessary for it to include the code identifying the diagnosis, as well as the services and procedures performed. Certified coders are used to carry out this task, as they know the coding process best and are equipped with the knowledge to code to the highest level of specificity. In order to prevent denials – and reduce compliance risks – it is also necessary for coders to work closely with physicians. By doing so, coders can properly identify illegible information and obtain missing data without having to guess what the physician intended to communicate. Billers can also help prevent denials by reviewing codes for omitted numbers (and double-checking with the coder, if necessary) before sending any claims.

3. Filing deadline is not met. Failing to submit a claim before the payer deadline will cause a denial, even if all of the information on the claim is accurate and complete. Therefore, it is important to know the filing deadline schedule for each payer and to have a list with these deadlines in plain view for all billing staff.

If your organization lacks the time, resources or FTEs to effectively handle claim submissions, resubmissions, appeals and denials, consider hiring a healthcare revenue cycle management company to do ir for you.

Source: http://www.mgma.com/store/Surveys-and-Benchmarking/Performance-and-Practices-of-Successful-Medical-Groups-2011-Report-Based-on-2010-Data-Print-Edition/

What is Medical or Hospital BPO?

Posted on November 28, 2012 by admin

Hospitals and medical providers are continuously looking for processes to help run their back office solutions more efficiently so that they can concentrate more heavily on their primary responsibility: patient care. By working with healthcare business process outsourcing (BPO) partners skilled in providing services for organizations similar to theirs, hospitals and medical providers are able to do just that – effectively manage their healthcare accounts receivables while maintaining strong patient-doctor relationships.

Healthcare BPO partners help alleviate providers’ struggles with decreases in revenue, capital and resources, and should be able to manage processes such as:

Appointment reminders and rescheduling services
Skiptracing and statement processing
Physician/hospital billing and follow up
Self pay and balance after insurance
Payment monitoring
Insurance follow up and denial management
Charity care and financial assistance eligibility
Website and payment portals
Collection services

Why would a hospital choose to outsource revenue cycle management processes?

When hospitals and medical practices are understaffed or underequipped, they often look to outside companies that are able to handle revenue cycle management processes more effectively and efficiently. Medical professionals who rely on healthcare BPO are able to:

Save money on hardware, software, FTEs, training, and other organizational costs
Focus on critical activities, such as patient care, by allowing BPO partners to take care of back office operations
Increase revenue by allowing trained experts to handle billing and collection processes
Achieve a higher rate of patient satisfaction by building stronger patient relationships

Though HIPAA and other healthcare compliance regulations may make hospitals and providers wary of outsourcing their business processes, choosing a BPO vendor within the United States allows healthcare organizations to comply with patient privacy regulations and security protocols with ease.

OutReach, LLC is a division of AR Logix, Inc. and was designed as a healthcare business process outsourcing company. Its purpose is to help providers facing depleting finances, losses in revenue, and staffing and resource shortages by creating customizable solutions to help manage these and other business process challenges.

Click here to learn more about what OutReach,LLC can do for your hospital or medical practice.

Listening Skills Key to Effective Medical Collections

Posted on November 21, 2012 by admin

Medical collections frequently involves contacting patients coping with stressful situations such as unemployment, serious illness, divorce, and even a family member’s death. In order to be successful in collecting from these patients, you must be sensitive to their situation and show empathy. The optimum approach with these patients involves active listening – not only hearing what the patient is saying, but understanding the message that is being communicated. This requires paying careful attention to what is being said and fully focusing on the patient.

Benefits of Active Listening

Helps reduce misunderstandings and organizational errors
Makes the patient feel that they are being heard and understood
Facilitates further disclosure from the patient
Increases patient satisfaction and builds trust
The patient feels respected and may be more willing to pay the balance

Here are three tips that will help you become a stronger active listener to collect more efficiently as a revenue cycle management representative:

Be aware of the amount of talking do while on the phone with a patient. As uncomfortable as awkward silences may be, after you have communicated your reason for making the call, stay silent. This will give the patient time to explain their situation. Keeping your side of the conversation short and direct will allow you to maintain control. During your call with the patient, steer the conversation toward your objectives by making appropriate comments and asking questions based on what the patient is saying.
Show the patient that you are listening. Making occasional comments or even using supporting words such as “yes” and “right” can encourage the patient to keep talking and also show that you are paying attention. An even better approach is to repeat back a key phrase or idea that the patient said in order to confirm that you understood what was said.
Provide feedback, but leave out personal judgment. To be an active listener you do not necessarily have to agree with what the patient is saying, but you do have to try to understand the message that they wish to convey. Try answering a patient like this: “I understand that you are currently unemployed, and I work with people in your situation all the time. Let me tell what I can do for you.”

For additional medical collections tips, contact AR Logix today.

Common Medical Collection Misconceptions

Posted on October 16, 2012 by admin

In order to collect from patients successfully, you must understand the medical collections process, as well as be aware of which techniques are acceptable and which ones are not. Below are two common medical collection misconceptions to help separate fact from fiction.

Fiction: Sending a collection letter is just as effective as making a telephone call.

Fact: Issuing statements and demand letters may be more convenient and less time consuming, but it is not necessarily as effective as making personal contact. Though it may be difficult to contact every patient whose account is outstanding, making a phone call may be required for those who have failed to respond to repeated statement and demand letters.
Also, calling patients at home outside of traditional office hours will increase the likelihood of contact. If your employees are not available in the evenings when the likelihood of contacting patients is greater, consider outsourcing your accounts receivable to a medical collection agency, such as Berks Credit & Collections. Experienced collectors will attempt to call patients at times that are most convenient to your patients – not only at times when your office staff is available to talk on the phone.

Fiction: Turning patients over to a medical collection agency is bad for business.

Fact: Utilizing a medical collection agency allows healthcare organizations to alleviate the cost and time of collecting on past due or delinquent accounts. When you put an experienced medical collection agency, such as Berks Credit & Collections, to work for your healthcare organization, you will be confident that your patients are handled with compassion and respect.
Professional medical collection agencies will drive to excel in upholding the patient-doctor relationship while resolving outstanding healthcare accounts receivable; this way you can continue focusing on your primary responsibility: patient care.

Collecting From Divorced Patients in a Shared Debt State

Posted on August 28, 2012 by admin

Going through a divorce can be a very frustrating process, especially when legal proceedings are drawn out due to joint assets and debts. Recent separations can result in financial strains for patients and can potentially lead to bill neglect. Oftentimes, one party may object to paying their ex-spouse’s medical bills, as they assume that the responsibility is no longer theirs. In a situation such as this, hospitals and medical practices’ healthcare debt collection efforts can suffer, especially if employees are not trained in collecting from divorced patients.

If you live in a shared debt state and the patient you are collecting from is unavailable to contact or unwilling to work with you, you have every right to seek remuneration from their ex-spouse – that is, unless they have a legal document stating otherwise. Being aware of your state’s collection laws is of great importance as collectors often assume that a medical debt pertains only to the patient who incurred the debt and not to their ex- or soon-to-be ex-spouse. If your state is a shared debt state, then both partners are liable for any medical debts incurred during the marriage. The reason for this is that, by law, medical expenses are seen as ‘necessaries,’ or basic requirements of life.

Do the same rules apply for patients in common law marriages?

The same laws apply to common law marriages, provided you live in a common law state. Provided that both parties were living under the same roof at the time the medical debts were generated, each person can be held responsible for the other’s medical expenses. If you are confused about the collection laws in your state, revenue cycle partners can help you figure out who you can legally collect from.

What if a patient claims that they are no longer legally responsible for their debt?

In some cases during divorce proceedings, a judge can divide a couple’s debts equally – or not so equally – amongst the two parties. If one spouse does not have a job, for example, the other might be ordered to pay the full amount of the debt, whether the medical bills were theirs or not. If the couple has accumulated multiple debts, one spouse might be given the responsibility to pay half of the bills and the other spouse would be given the other half.

Ultimately, if you want to avoid the most amount of hassle, the best way to find out who is responsible for the medical debt owed to your organization is to simply ask your patient. If necessary, request a copy of the legal document that outlines their payment responsibility. Keep in mind that if you are provided with a legal document that specifically states who is fully responsible for paying off the debt owed to your practice, you are unable to initiate healthcare debt collection efforts against their ex-spouse.

Collecting from divorced patients can be complex, but it is important to be familiar with the process. If you are unfamiliar with your state’s collections laws regarding separated or divorced patients, consider seeking the advice of experienced revenue cycle partners to guarantee that your collections tactics are in line with the law. For information about state laws and other collection resources, click here.

Healthcare Debt Collection Training: A Benefit to Patient Satisfaction

Posted on August 21, 2012 by admin

Great collection practices start before a patient ever walks into a medical facility. Because there are so many steps involved in the revenue cycle management process, it is important to establish a healthcare debt collection policy for your office that all employees are able and expected to follow. A clear cut policy combined with customer service and collections training for staff members will ensure patient satisfaction and a healthy accounts receivables balance.

How will my healthcare organization benefit from debt collection training?

By fine-tuning you practice’s front-end processes, your employees will spend less time and effort on back-end tasks. For example, your revenue cycle partners should do their part to verify insurance eligibility prior to a patient’s visit. Meanwhile, front desk employees should collect updated demographics and make sure the data is entered accurately into your practice management software. If your organization emphasizes teamwork and makes sure that each person is doing their job right the first time, each subsequent task should flow more smoothly.

How can staff members extend their collections training to patients?

Collecting from patients at the time of service requires your patients to know that payment is expected up front. Here are a few ways you can make sure your patients are aware of your collections policy and that they understand their financial obligations to your practice:

Do you have a patient portal with appointment request capabilities? Configure it so that patients are required to review and accept your payment policy before confirming the appointment.
If you don’t have a patient portal, be sure to tell patients while confirming their appointment that payment is expected before they see the doctor. When a patient checks in for their appointment, have them sign a document that states that they have read and understand your payment policy. It is not enough to simply have a sign up at your front desk that states that co-pays are due at the time of service.
At the time of scheduling, obtain a current phone number from the patient, as well as any health insurance information. If the patient has insurance, ask them to bring their card and co-insurance payment with them to the appointment. If the patient is unsure as to how much their insurance requires them to pay up front, tell them you will found out and get back to them.
If the patient does not have insurance, inform them of the amount that they should be prepared to pay prior to the services being rendered.

How will patients benefit from debt collection training?

Explaining your debt collection policy to patients and outlining their financial obligations can benefit patients who do not understand what their insurance covers, what it doesn’t, and why. If your staff members are able to explain to the patient why they are responsible for a certain portion of the bill, the patient is likely to feel more comfortable about paying.

See the benefits of healthcare debt collection training firsthand by choosing expert revenue cycle partners for your medical organization.

Front Desk Preparation Facilitates Medical Bill Collections

Posted on August 8, 2012 by admin

Front office employees are responsible for many important tasks within your organization. Not only are they the first and last people your patients have contact with, but they are also responsible for collecting crucial information for insurance claims and medical bill collections processes. With proper training and preparation for front desk staff, your hospital or practice will run more efficiently.

Demographic and insurance verification are key.

One of the most important tasks for front office employees is verifying patients’ demographic information. This should be done every time a patient comes in for services in order to prevent claims denials due to outdated or incorrect data.

Insurance information, on the other hand, should be collected at the time of scheduling so that coverage, benefits and eligibility can all be verified ahead of time. Outsourcing this task to revenue cycle partners can ensure insurance eligibility gets verified no less than 24 hours before a scheduled appointment. If a patient is not covered for certain procedures – or at all for any services at your facility – they should be notified prior to their appointment so that they can either reschedule or be prepared to provide payment at the time of service.

Establish a policy and stick to it.

Once patients understand that their payment or co-payment is due at the time of service, they should be adequately prepared for subsequent visits. Try to follow your financial policy guidelines as closely as possible to prevent conflicts. It might reflect badly on your organization, for example, if you allow one patient to call their payment in later but deny services to another for having forgotten their credit card at home.

Training goes a long way.

Have your staff go through collections and patient account management training in order to understand the overall importance of each task they perform and how it affects your patient experience and satisfaction. If employees have a good grasp of their responsibilities in the medical bill collections process and understand why certain information needs to be collected, they will be less likely to leave out crucial steps.

Front desk staff can also benefit from training on interaction with sick patients. Employees should keep in mind that patients who are ill require a different type of treatment than someone who is healthy. Employees should do their best to emit patience, kindness and understanding 100 percent of the time.

Tips for Tactful Time of Service Collections

Posted on July 25, 2012 by admin

Collecting from patients at the time of service is crucial to the financial well-being of your medical practice or hospital; however, this simple step is often forgotten or not enforced. Whether your medical facility is implementing a new time of service policy or trying to enforce an existing one, it will take some getting used to, both for patients and staff. With some adjustment time and healthcare collections training for employees, your healthcare organization should see a positive change in the health of its accounts receivables.

Plan Ahead

Do your patients know before they walk in the door that they are expected to pay their co-pays or deductibles before their appointment? Make sure your employees mention this when scheduling appointments, and consider including a note about this policy with your appointment reminders.

Also, whenever possible, let patients know how much they can expect to pay ahead of time. Giving them an idea of their financial responsibility beforehand will increase the likelihood of on-time payment.

Ask the Right Questions

Remember that it’s not about how many times you ask but about how the asking is done. If your office is enforcing time of service collections, then patients should never be asked whether they are going to pay or not. Instead, staff should focus on questions such as, “How will you be paying your co-pay today?” and letting patients know what the different payment options available are.

Know Your Policy

If a patient declines to make their payment, make sure staff members are ready with scripted answers. Will your practice turn patients away? Will you try to set up payment plans? Are patients allowed to call or mail their payments in later? Whatever your policies are, your employees should know and understand them well.

Interested in learning more about healthcare collections and accounts receivable training? Click here for information about our healthcare seminars, collection resources and other training tools.