“In the middle of difficulty lies opportunity.”
Quoted from Albert Einstein but a true rally cry for any health care organization these days.
In the lab world specifically, the difficulty: despite the country’s rebound from a recent recession, many Americans struggle to pay their bills and lab-related services are often a lower priority. The difficulty to get patients to pay, or pay in a timely manner, presents common problems for laboratories.
The opportunity: With payer reimbursement steadily declining and the shift to high deductible plans, the opportunity to increase cash collections can be traced to improving the collection of patient copays, deductibles and coinsurance amounts. Best practices say labs should collect these upfront, but reality shows this is extremely challenging.
Translating the challenge of patient collections into a business opportunity can only be realized by developing compliant, cost-effective patient billing processes that are incentivizing patients to pay and pay quickly.
Here are four solutions to increase collections thus increasing profitability.
- Patients don’t know who you are. Laboratory services are an important part of the patient’s continuum of care; however, patients rarely know the lab that processed their specimen. As a result, there can be hesitation for the patient to pay. “Who is this and why would I pay them?”
The action to take: Leverage letters in TELCOR RCM to introduce your organization and notify them a bill could be in their future. Being proactive and engaging patients before a bill is generated can help elevate the priority of lab services on their list of personal financial obligations.
2. Fear. As one customer told me, “I can’t afford too many patient bills on the street as it will be bothersome to the patient and we may lose clients.” Organizations are concerned about how to make a good faith effort to bill patients yet not overwhelm them.
The action to take: Plain and simple, you need to bill and make best efforts to collect from patients to avoid an inducement issue. TELCOR RCM provides clearly defined statements with easily understood messaging. Patient statements can be generated automatically via a customized schedule and distributed evenly thus patient calls are spread out appropriately.
3. Patients have no incentive. Let’s be real, patients have a financial obligation to pay for services rendered. But if we really expect them to find an envelope, stamp and their checkbook, then we can expect little to no patient cash coming through the door.
The action to take: Develop a dedicated plan for patient payments. And by plan I mean a Plan A, Plan B, Plan C and Plan D—a multi-faceted plan providing options.
Plan A: Promote and accept credit card payments through TELCOR RCM.
Plan B: Leverage TELCOR iLabBill®, an online patient portal where patients can elect to receive statements via e-mail, easily pay their bill online, or notify the laboratory through the portal that they have insurance and provide information on the specific payer.
Plan C: Offer payment plans with high balances and promote this option through balance-specific messages on your patient bills or via account letters.
Plan D: Everyone likes a deal. A prompt-pay discount can be easily configured in TELCOR RCM to incentivize patients to pay early. To truly up the ante, TELCOR RCM provides the ability for client contract pricing to be offered to true self-pay patients…now that’s a deal!
4. The effort is not worth the reward. We all know patient billing is not as straight forward as it seems. For example, many labs want to provide a financial adjustment to uninsured patients who obtain medically necessary services, but identifying these patients, performing the adjustment, and maintaining other patient billing activities can be a chore.
The action to take: Within TELCOR RCM, automatic adjustment rules can be defined for specific patients. Whether these patients are identified by financial class or attention flag, their balances can be adjusted by a percentage, by a fee schedule amount, or by adjusting the complete amount.
Automatic adjustment rules provide workflow efficiencies so the billing team can focus on increasing collections while TELCOR RCM works behind the scenes to manage special adjustment situations.
Patient billing is a real challenge. To be compliant and to bolster cash, an effort must be made to collect. If you’re looking for a silver bullet or a single solution to turn your patient billing problem into a business opportunity, then explore the options within TELCOR RCM. It’s the only solution allowing organizations to deploy an efficient patient billing campaign to mitigate the challenges of collecting patient cash.
Remember, it’s your bottom line…push the limits.
Kwami Edwards, vice president, RCM implementations, has more than 15 years of health care experience with a strong background in workflow redesign and change management. In his current role, Kwami works with owners and executives to help ensure successful implementations and continued reengineering support.