Problems Solved: 3 Issues Plaguing Healthcare Providers & Their Solutions – #3 Rising Bad Debt

Missed Opportunities for Healthcare Revenue Infographic


Healthcare providers are faced with ever-changing industry standards, regulations and restrictions. The presenters at this year’s New Jersey HFMA Annual Institute shed some light on three issues plaguing the industry under the current reforms, and offered various solutions to help providers not only to succeed, but to thrive in today’s environment.

In the first two articles of this three-part series, we discussed possible solutions to high rates of insurance denials and rising self-pay AR. This final article will provide you with tips and best practices to combat what is likely the largest issue with your AR.

Issue #3: Rising bad debt

As self pay AR rises, so does bad debt. Those patients who have lost coverage and taken on higher medical expenses contribute to the increase in bad debt, but there are a number of other missed opportunities for collecting revenue.

Despite the enactment of the Affordable Care Act, 13.4 percent of Americans are still without health insurance.  While this number is down from 18 percent at the end of 2013, there are still millions of people who have no coverage at all but are still seeking medical care.

Additionally, according to New Jersey HFMA Annual Institute presenters Ric Perez and George Wong, in 2012 at least 18 percent of those uninsured people qualified for Medicaid, and the percentage of people eligible for Medicaid will only grow with the expansion. They also cited that in 2012 nearly two thirds of Medicaid eligible children were not enrolled.

Finally Perez and Wong shared that a recent study by Experian found that up to 15 percent of self-pay accounts had Medicaid coverage that was missed or not applied.

Solution #3: Create exceptional vendor relationships

The Affordable Care Act was passed to decrease the percentage of uninsured people in the country, and roughly 10 million more people have health insurance today than prior to the mandate. With the exchange opening again in a few weeks, the number of uninsured should decrease even further.

The proposed IRS regulations setting strict standards for the dissemination of information on financial assistance will also help to reach those people who are eligible for Medicaid but remain uninsured.

For those who are insured, the HFMA has set forth best practices and recommendations for collecting the balances of self pay and underinsured patients.

  • Set forth clear and concise payment and collection policies and procedures;
  • Make sure patients understand and agree with charges;
  • Know and offer all assistance options;
  • Knowing coverage and eligibility information in real time is key;
  • Be fair, balances and compassionate;
  • Make use of scripts for collections; and,
  • Embrace technology, having validated financial information can increase collections by up to 20%, increase productivity and provide you with the real-time information that you need.

The right third party collection vendor can help practices comply with these best practices, and can provide the technology, skills and time that provider’s offices may not have. For more on why a great relationship with a third-party provider can help your practice, read our guest blog post by Attorney Elizabeth Richards, an ACA Convention & Expo presenter.

Read Article 1 of this series: High Rate of Insurance Denials

Read Article 2 of this series: Rising Self-Pay AR

Written by Ali Bechtel, Public Relations Coordinator

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.

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