Revenue Cycle Strategies for Managing Patient Accounts Receivable

Managing Patient Account Receivables

A Guide to Accounts Receivable (A/R)

The healthcare practice’s Accounts Receivable (A/R) encompasses various complexities and subtleties. The Accounts Receivable process is continually evolving, presenting numerous challenges. Although A/R challenges may not solely determine success, improving A/R turnaround time can have a significant impact. Based on an MGMA Stat poll, 56% of medical groups reported an increase in their A/R time in 2022.

The key challenges faced by respondents in handling collections and A/R days included:

  1. Difficulties in billing and collections.
  2. Escalation in prior authorizations.
  3. Heightened demands for documentation, coding, or review notes.
  4. Additional time required to understand the Electronic Health Record (EHR).
  5. Issues related to credentialing.

Effectively navigating through these A/R challenges and finding viable solutions can revolutionize your medical practice. With the guidance of Greenway Health, let’s explore strategies involving workflows, patient education, patient costs, and financial policy. By integrating these elements cohesively, we can establish a science of best practices in A/R management.

Strategies for Mastering Workflows

Healthcare providers in the front office play a crucial role in the overall efficiency of a healthcare group, and it is essential for them to thoroughly assess their workflows before patients’ arrival. They must ask themselves: Have we thoroughly analyzed our front office workflows? The front office staff serves as the voice and face of the practice, making patient interactions a critical part of the overall patient experience. Their efficiency impacts all operations within the healthcare group, making them vital ambassadors for the practice’s success.

According to a recent survey by the American Society for Quality (ASQ), 78% of healthcare quality experts believe that improved clinical workflow and efficiency are key factors in enhancing health information technology quality.

The accuracy of information, ranging from insurance details to demographics, begins with the front desk check-in process. Front office workers should collect communication updates, policyholder information, policy IDs, preferred communication methods, and patient portal access details during check-in. For existing patients, the front-office staff must verify primary, secondary, and tertiary insurance information, inquire about coordination of benefits, and ensure that the patient’s demographic information is accurately entered for insurance claims. By collecting outstanding bills at the front desk before the patient sees the physician, a strong and trusting start is established for both the patient and the healthcare provider.

As a best practice, it is advisable to rerun insurance availability checks at least two days before the appointment. This step helps avoid surprises during the check-in process and ensures a smooth experience for the patient.

Furthermore, when scheduling a new appointment, the front office should gather as much demographic information as possible to prevent revenue leakage anywhere in the revenue process, which could adversely affect cash flow.

In conclusion, optimizing front office workflows is essential for healthcare providers to create a positive patient experience and ensure the success of the entire practice. By paying attention to details, accuracy, and efficiency in the front office, healthcare groups can enhance patient satisfaction, streamline operations, and maintain a healthy revenue flow.

The Vital Role of Education in Healthcare

In addition to workflows, patient education and economic responsibility play crucial roles in determining revenue streams. Firstly, patient education is of utmost importance as it ensures that individuals are well-informed about their health, medical conditions, and available treatment options. By equipping patients with comprehensive information, they feel empowered and capable of making informed decisions about their healthcare. When patients actively participate in their health journey, they are more likely to adhere to treatment plans, resulting in improved outcomes and better overall health.

Secondly, strong leadership qualities are essential for physicians, healthcare organization leaders, administrators, and front office staff to effectively educate and inform patients. Healthcare IT companies can contribute to increasing revenue and promoting leadership qualities among the practice’s staff members by prioritizing staff training and patient education. As highlighted in a piece published by MGMA Insight Article in September 2022, providing educational content focused on self-leadership, relationship management, business acumen, and integrating this knowledge into practice can be highly beneficial. Through education and leadership training, healthcare professionals can enhance their abilities in process improvement, project management, and developing effective business plans.

In summary, patient education is a powerful tool for enabling informed decision-making and better healthcare outcomes. Concurrently, fostering leadership qualities among healthcare professionals through education and training can lead to process improvement, enhanced project management, and increased revenue for the practice. By prioritizing these aspects, healthcare organizations can create a more patient-centered approach and build a strong foundation for sustainable growth.

Unveiling patient costs and accountability

In recent months, a noticeable trend has emerged with patients delaying the payment of their medical bills due to high deductibles in their health plans. Consequently, medical practices are finding themselves in the role of creditors, seeking ways to collect payments, while patients explore various options for settling their bills. These options include pay by mail, pay by phone, easy recurring payments, using cards on file, online income, mobile pay features, and financing.

To address this situation, two essential conversations must take place. Firstly, the medical office must commit to transparency, ensuring that patients are informed about their financial responsibility beforehand. This means communicating the patient’s outstanding balance and commitments before their visit, along with any upcoming billing charges they can expect to incur during their visit. Secondly, before the visit, patients should be educated transparently about how the cost of services may vary based on specific treatments or procedures. For payment plan options, it is advisable to start with higher amounts than expected and provide a detailed breakdown of expenses while allowing time for discussions on potential variations in costs. Additionally, it’s important always to provide information about financial assistance programs if needed. The front office staff should be well-prepared to engage in these discussions.

When dealing with patient balances from previous visits, it is essential to have specific discussions about the services rendered and the associated costs. For payment negotiations, starting with higher amounts and then working towards a resolution that benefits both the patient and the practice can be effective. This process should also involve informing patients about available financial assistance programs if applicable.

While discussing patient responsibilities and older balances can be challenging, it is crucial to approach these conversations with professionalism, politeness, and compassion. Avoid any judgmental or accusatory tones when communicating with the patient, and prioritize their understanding of the situation and potential payment options.

In conclusion, handling patient payment delays due to high deductibles requires open and transparent communication about financial responsibilities, cost variations, payment plan options, and available financial assistance programs. By approaching these discussions with empathy and understanding, medical practices can foster better relationships with their patients and navigate through these financial challenges more effectively.

Tips for Financial Policy:

A well-crafted financial policy is essential for the daily operations of any healthcare practice. To maintain transparency with patients, it is crucial to proactively inform them about financial matters before they see the physician. When drafting the policy, use clear and easily understandable language, avoiding technical terms or office jargon that might confuse patients. By doing so, you can establish trust and prevent misunderstandings.

A solid financial policy also ensures that your practice does not end up acting as a creditor. Well-designed and straightforward payment plans can be implemented, making it easier for patients to meet their financial obligations.

Regularly managing and monitoring accounts is crucial to identify and rectify data entry errors promptly. Regular review of patient aging reports and setting specific days for checking patient balances can help stay on top of financial matters.

If these measures prove insufficient in recovering outstanding payments, consider partnering with a debt collection agency for severe cases. This step can help you recover debts while allowing your team to focus on patient care.

When issuing patient statements, follow best practices. Provide a phone number for billing questions, but avoid displaying the balance aging on the account or showing credits. Some patients may view aging on the statement as more time to pay, and displaying credits might confuse them. By presenting clear and concise statements, you can streamline the payment process and reduce confusion.

Finally, it is crucial to review and update your financial policies regularly. Revisit the policies every six months to ensure they align with any changes in regulations, industry standards, or the needs of your practice.

By implementing these tips for financial policy, your healthcare practice can foster a transparent and efficient payment process, ultimately benefiting both your team and your patients.

Final implementation of best practices

By implementing efficient workflows and employing well-trained staff, you can effectively reduce costs while also fostering trust and respect with your patients. Having a highly qualified team is crucial for building strong patient relationships. To enhance the effectiveness of your operations and increase patient accounts receivable, it is essential to adopt some best practices as a foundation. Additionally, identifying and addressing any sources of inefficiency will further boost revenue. Following the guidance and principles set forth by your revenue cycle manager will prove beneficial. By demystifying and resolving any confusion, we can collectively find inspiration and drive towards success.