Revenue Cycle Management
Healthcare Blog

Is Your Revenue Cycle Management System Enough?

Are you receiving patient payments in a timely manner – or at all? While revenue cycle management systems streamline the payment process, you may still be struggling to collect amounts due from some of your clients. Post-insurance balances often are owed by patients. Sometimes, legitimate insurance claims are denied because of faulty or incomplete information. Rather than initiate a lengthy collections process with patients, dispute insurance payment denials or (don’t say it) write off bad debt, you can take steps to help close the loop on the patient pay revenue cycle.


Identify and Explain Costs to Patients

As healthcare plans change and patients opt into new ones, payment responsibilities become confusing. Believing services are (still) covered by insurance policies, patients refuse to pay for services rendered. To avoid these scenarios, patients should understand the types of chargeable services anticipated for their visit such as exams and lab work. A quick call prior to an appointment can eliminate lengthy, heated discussions at the office and give patients time to verify costs with insurance companies. By providing transparency into service costs, you also build trust with patients who are more willing to pay upfront instead of disputing surprise charges down the road.

Verify Insurance and Benefits

Take the time to review patient insurance eligibility and benefits prior to rendering services. Do they understand their own insurance coverage? Are you a participating provider? Has insurance coverage lapsed? Ensure insurance policies are current and benefits cover your services and goods. Patients should know upfront if they must pay premiums for out-of-network or specialist services. And if insurance cannot be verified, establish policies that stipulate patients must pay for services in full and file their own insurance claims.

Get Patient Payments Upfront

Having informed patients of their financial responsibility for services prior to an appointment, you can complete the payment process by asking patients how they wish to pay at date of service. As insurance deductibles increase exponentially, patients may be shocked at their financial responsibility. Understanding anticipated costs, patients are more willing to pay up front, making the process a lot easier than collecting at the back end. Many hospitals are following the trend to bill patients prior to leaving the hospital or work out payment plans with their billing departments. Any portion of payment received at time of care is better than collecting the entire balance at a later date.

Get Outsource Expertise

Even with revenue cycle management systems in place, it may make sense to outsource expertise to move along the payment process. For example, VARO’s PIN team members work directly with patients who receive requests for additional information from insurance companies to facilitate claims. VARO’s qualified insurance teams, also, are experts in working through the red tape with insurance companies to recover owed money while reducing your patients’ payments.

Training is Key

Best-in-class standards and processes only work as well as those who manage them. Staff must be trained to properly execute procedures for patient billing, office payments, and insurance coding to support your revenue cycle. Your employees also provide the first experience with patients and help to build long-lasting “client” relationships that are the cornerstone of your business.

Download 6 Tips for Closing the Patient Pay Revenue Cycle that serves as a guide to hospitals, physician networks, medical device manufacturers and other healthcare providers in proactively closing the gap in patient payment collections.

Streamline Your Healthcare Payments with this Free Tip Sheet. Download 6 Tips for Closing Your Healthcare Revenue Cycle.

Topics: Revenue Cycle Services, Revenue Cycle Solutions