Tag Archives: Medical practice

How Debt Collection Affects Revenue Cycle in Healthcare

2 Apr

medical-debtDebt collection is a hot topic in healthcare revenue cycle circles. That’s because hospitals are facing higher costs, declining reimbursement, along with high-deductible insurance policies and patients that simply cannot afford to pay.

This article looks at how debt collection best practices could improve the revenue cycle in healthcare. What are the issues affecting debt in healthcare?

Debt Collection and Medical Billing 

Medical billing serves at the core of healthcare revenue cycle. But Rev Cycle Intelligence points out the elephant in the room: Medical billing is often riddled with errors.

Simple mistakes in the patient billing record are a challenge in the revenue cycle. Collecting patient information at the front desk lays the reimbursement framework that every revenue cycle is built upon.

When you cull out simple human mistakes, providers are still left with the complexities inherent in billing practices that are unique to every payer. That alone creates glitches in clinical cash flow when reimbursements are submitted and rejected by the payer.

Another problem with medical billing is tied to the healthcare paradigm itself. It is a patchwork of disparate providers – even within a single health system. If the steps to getting paid hinge upon a previous interaction, but documentation are peppered with missing pieces, the likelihood of that provider being reimbursed by a payer drops with every missed checkbox.

A frequent issue that occurs well before the bill is generated is the issue of collecting a patient’s co-pay. Even when the co-pay is $20, the medical practitioner at the front desk may fail to collect it. For clinical administrators, it can be difficult to ask for payment from a sick patient. Now imagine the struggles when a patient has a $2,000 deductible. But failing to collect this revenue up front does nothing to alleviate patient responsibility for their bill. In fact, it almost certainly guarantees the need for debt collection later. Rev Cycle Intelligence states that 90% of the 12.7 million Americans participating in 2016’s open enrollment had high deductible insurance.

InsideARM has been waving a red flag around this issue, citing statistics that say, “The percentage of consumers not paying their total hospital bills will increase to 95 percent by 2020.” Even worse news for hospital revenue cycle, the volume of patients who are only paying a part of their overall hospital bill has declined from around 90 percent in 2015 to 77 percent in 2016.

As bad debt rises, healthcare providers are turning to debt collection agencies to help save their revenue cycle.

Debt Collection Improves Healthcare Revenue Cycle

TSI specializes in debt collection in the healthcare space. With over 45+ years of healthcare collection experience, we use an empathetic approach to collections to protect the patient relationships you’ve worked hard to cultivate. We understand the delicacy inherent in keeping patient satisfaction scores high while still collecting on an unpaid medical debt. That’s why we’ve invested in technology that can help us collect on all bad debt in ways that acknowledge and respond to patient payment preferences across multiple digital venues as well as through more traditional formats.

In addition, our proprietary data analytics platform, CollectX boosts your results by identifying the most liquid accounts and ensuring they receive the appropriate collections activity. Since implementation of CollectX, our clients have seen on average a 22% lift to their liquidation rates. Maintain your patient relationships, while improving your revenue cycle, with TSI.

To learn more about how to optimize your revenue, contact me today at 888-780-1333 or at david.wiener@cashflowstrategies.us.

RECOGNIZING THE FOUR PATIENT PAYER TYPES

20 Mar

The way that healthcare approached patient payers in the past no longer works nearly as effectively as it once did.  With the dramatic rise in high deductible health plans (HDHP) and higher co-pays, collecting patient balances quickly and effectively is imperative.  The “one size fits all” approach is dead, both in follow-up and collections of slow-pay and delinquents accounts.

Reasons for a patient not paying the bill when due can be varied.  Some don’t pay on time because of financial reasons, many times because of the high deductibles in their health plan.  Others have the funds but, due to confusion surrounding their insurance policy, aren’t sure the balance is correct.  Others are simply too disorganized to remember to find the statement and pay the bill when they have the money.  Still others feel that their insurance has paid enough and the practice should be satisfied with that.  Some will say, “that doctor is rich, he doesn’t need my money!”

It is a delicate balance that practices must strike to be aggressive enough to motivate the patient to pay the bill without being so aggressive that the practice risks losing what might be a profitable patient in the future.  Some practices spend great deals of money with internal follow-up through statements, phone calls and letters, not realizing that each contact with a patient in follow-up internally can cost the practice between $10-12.  That expense, not to mention the staff time and attention this takes, can wind up making the whole follow-up proposition more expensive than it is actually worth.

So what is a practice supposed to do?

We, at TSI (formerly known as Transworld Systems) have determined that there are actually four distinct types of patient payers.  Each is motivated in a different way to pay the bill, and it is a mistake to treat them all the same.  They are:

THE DUTIFUL PAYER

The dutiful payer feels a keen responsibility to pay their debts in a timely manner.  They are motivated to pay the bill by the initial statement you send following patient responsibility.  Fortunately, they are (or should be) the largest category in your practice.

THE DISTRACTED PAYER

The distracted payer has the very best intentions to pay your bill, but they seem to be so busy and distracted that they misplace your statement or just forget to pay it.  Timely reminders are sufficient to motivate them to get that bill paid.

THE DISRESPECTFUL PAYER

The disrespectful payer tries to see what they can get away with, and hope that you will give up trying to collect the bill if they dodge you long enough.  They do not respond to your statements, letters, or phone calls.  Rather it will take a contact by a third party collection agency for them to be convinced that the practice is serious about collecting the debt.  That alone will motivate them to pay, and they will generally pay the bill after they receive the first contact by that third party.

PROFESSIONAL DEBTOR

The professional debtor never intended to pay the bill when they received service.  They are likely in collections with other creditors already.  These, and these alone, need to be in the hands of professional collectors, familiar with medical debt, before too much time has elapsed and too much money has already been spent chasing them.

TSI offers a free interface that works with virtually all dental software to help you identify which type of category each patient falls into, and tools to communicate with them in an appropriate manner.  The practice retains control of each account, and the type of communication that is being used on a particular patient.  These tools eliminate the need for the practice to continue time-consuming internal chasing of accounts at a cost that is generally less than they are spending on follow up currently.

For a full description of the tools and services provided by TSI, please call 888-780-1333 to speak to me personally, or email me at david.wiener@transworldsystems.com.

 

Not all Debtors are created equal!

27 Feb
After being in the ARM (accounts receivable management) industry now for many years, I can honestly say I’ve heard almost every story in the book from CEOs, CFOs, healthcare administrators, doctors, dentists, lawyers, accountants, billing managers to janitors as the reasoning or excuses from clients as to why their outstanding balance had not been paid.
Here are some common excuses:
  • They have been traveling.
  • They just lost their job.
  • They just moved and were not getting the invoices.
  • They came across financial hardships and needed some extra time.
  • They just had surgery and have been in the hospital so needed some time to get their things organized.
  • They weren’t satisfied with the service or product so didn’t feel the need to pay for it.
  • They were used to paying all their vendors after 60 or 90 days.
Here are some off-the-wall responses:
  • They said they were going to get their checkbook from their car and never returned.
  • They didn’t remember ever ordering that product or service.
  • They’re going through a divorce and to call the soon to be ex-spouse who is responsible for the balance, not them.
  • They were wondering if their creditor would be willing to barter instead.
It might seem odd to hear even the common excuses listed above if you aren’t in a business that extends credit or if you are in general a good paying consumer.
It may even seem like an episode from a spin off series of the Twilight Zone where customers walk into Costco, load their shopping carts full of items, walk past the cash registers, give the friendly greeters their mailing address to send them a bill and walk right out.  Luckily for Costco, it isn’t the case as they don’t extend credit (only through a 3rd party financing credit card partner).  Unfortunately for millions of other businesses around the world that essentially happens every day.
In my opinion the most vital thing to understand if you are in a business that extends credit or carries an accounts receivable is:
NOT ALL DEBTORS ARE CREATED EQUAL
I explain to my clients that they’re only going to have to deal with 4 types of payers.  I laughed the other day when a client told me that 4 payers is 3 more than he’d care to deal with.  Can you blame him?
Here are the 4 Payer Types:
  1. Dutiful  (Always pays their bills on time, probably has an 800 or higher credit score.)
  2. Distracted (That busy working professional who is good for the money but hasn’t yet gotten to all 10-12 monthly bills on their kitchen table.  They simply need a reminder text, email, phone call, letter and they’ll pay up.)
  3. Disrespectful (Has disregarded and ignored at least 2 billing cycles from the same creditor and hasn’t called to explain or apologize about non-payment.  Are paying some bills more timely, but they have chosen which bills to put off that don’t seem so urgent.)
  4. Deliberate (Have expressed to their creditor verbally that they will not pay the balance owed or expressed through non verbal cues of long periods of silence, mail returns and disconnected phone lines.  These are the most high risk debtors.)
Now be honest with yourself, which category do you fall under?
I want to note that, in my experience, these 4 payers types are found in all socio-economic income levels, meaning some wealthy people fall into the category of Deliberate high risk debtors while people from low income levels can be in the category of Dutiful payers.
I won’t get to into details about the psychology of why these 4 types of payers/debtors respond, react or do nothing in this article.  What I can tell you is by simply understanding that there are 4 payer types and that not all debtors are created equal puts you FAR ahead of the game and your competition.
The BILLION DOLLAR question is how do I efficiently and professionally address each of the 4 payer types to recover my past due balances? (That is if you’re in a business that extends credit, if you don’t have to worry about this then lucky you!!)
I would love to hear your comments, create some dialogue around the 4 payer types and hear your ideas on how your business effectively maximizes your accounts receivable in-house.

Cash Flow For The Medical Practice

25 Feb

I was a guest on the Top Docs Radio Program on Business Radio X, talking about Cash Flow For the Medical Practice with host, CW Hall.  Here is what he wrote about the interview:

LISTEN TO THE INTERVIEW BY CLICKING HERE

I sat down with David Wiener, aka “Mr. Cash Flow” on this week’s episode.  I connected with David first on LinkedIn a few weeks ago.  After learning more about the various ways he is able to help a medical or dental practice recapture revenue that is currently being lost, I knew I needed to have him on the show.

David spent numerous years as a practice manager for a doctor’s office, so he knows very well the challenges these practices face trying to maximize the revenue they get to keep for the care they provide.  With patient out-of-pocket obligations significantly on the rise, physicians are experiencing a corresponding increase in the number of patient balance bills they must collect upon to be paid for their services.

David provides access to a service that for only $12 per claim (instead of a typical % of the amount to be collected), that dramatically increases the success rate for bills collected to over 80% in the first 30-45 days from date of bill.

We also talked about other ways Cash Flow Strategies, Inc., is able to help their medical and dental practice clients drop more revenue to the bottom line.  One such way is to enroll their staff into a wellness program as provided for by the ACA.  Businesses that do so can save as much as $500 per employee per year on the Federal income tax they must pay for each of them.  Additionally, as employees take advantage of these wellness benefits, they tend toward better levels of health, decreasing the company’s expenditure for health benefits.

David also talked about a company he’s partnered with that can help a business change all the lights within the building to LED lights, saving enormous amounts of money on utility bills.  They offer a plan through which the business can pay for the lights over time, with the payments + new utility bills amounting to less than previous utility bills were, providing savings from the first month.

There are several other ways David is likely able to reduce amounts being spent by the business, such as procurement costs for necessary supplies through a competitive group purchasing organization and others.  It is clear that any medical or dental practice can benefit from taking a few minutes to talk with David to determine just how much additional revenue they can capture—all without having to work longer or harder.

For more information on how this might help your practice, call David at 888-780-1333 or email him at david.wiener@cashflowstrategies.us

 

 

RECOGNIZING THE FOUR PATIENT PAYER TYPES

12 Feb

The way that healthcare approached patient payers in the past no longer works nearly as effectively as it once did.  With the dramatic rise in high deductible health plans (HDHP) and higher co-pays, collecting patient balances quickly and effectively is imperative.  The “one size fits all” approach is dead, both in follow-up and collections of slow-pay and delinquents accounts.

Reasons for a patient not paying the bill when due can be varied.  Some don’t pay on time because of financial reasons, many times because of the high deductibles in their health plan.  Others have the funds but, due to confusion surrounding their insurance policy, aren’t sure the balance is correct.  Others are simply too disorganized to remember to find the statement and pay the bill when they have the money.  Still others feel that their insurance has paid enough and the practice should be satisfied with that.  Some will say, “that doctor is rich, he doesn’t need my money!”

It is a delicate balance that practices must strike to be aggressive enough to motivate the patient to pay the bill without being so aggressive that the practice risks losing what might be a profitable patient in the future.  Some practices spend great deals of money with internal follow-up through statements, phone calls and letters, not realizing that each contact with a patient in follow-up internally can cost the practice between $10-12.  That expense, not to mention the staff time and attention this takes, can wind up making the whole follow-up proposition more expensive than it is actually worth.

So what is a practice supposed to do?

We, at TSI (formerly known as Transworld Systems) have determined that there are actually four distinct types of patient payers.  Each is motivated in a different way to pay the bill, and it is a mistake to treat them all the same.  They are:

THE DUTIFUL PAYER

The dutiful payer feels a keen responsibility to pay their debts in a timely manner.  They are motivated to pay the bill by the initial statement you send following patient responsibility.  Fortunately, they are (or should be) the largest category in your practice.

THE DISTRACTED PAYER

The distracted payer has the very best intentions to pay your bill, but they seem to be so busy and distracted that they misplace your statement or just forget to pay it.  Timely reminders are sufficient to motivate them to get that bill paid.

THE DISRESPECTFUL PAYER

The disrespectful payer tries to see what they can get away with, and hope that you will give up trying to collect the bill if they dodge you long enough.  They do not respond to your statements, letters, or phone calls.  Rather it will take a contact by a third party collection agency for them to be convinced that the practice is serious about collecting the debt.  That alone will motivate them to pay, and they will generally pay the bill after they receive the first contact by that third party.

PROFESSIONAL DEBTOR

The professional debtor never intended to pay the bill when they received service.  They are likely in collections with other creditors already.  These, and these alone, need to be in the hands of professional collectors, familiar with medical debt, before too much time has elapsed and too much money has already been spent chasing them.

TSI offers a free interface that works with virtually all dental software to help you identify which type of category each patient falls into, and tools to communicate with them in an appropriate manner.  The practice retains control of each account, and the type of communication that is being used on a particular patient.  These tools eliminate the need for the practice to continue time-consuming internal chasing of accounts at a cost that is generally less than they are spending on follow up currently.

For a full description of the tools and services provided by TSI, please call 888-780-1333 to speak to me personally, or email me at david.wiener@transworldsystems.com.

 

Don’t Miss This Great Business Tax Credit

1 Feb

In 2104, Congress approved a tax credit for businesses as a part of the Affordable Care Act.  Don’t miss out on this tax credit that could save employers thousands, tens of thousands, and even hundreds of thousands each year.

Medical and Dental Practices, What Would You Do?

7 Jan
WWYDLogoWhat would you do if your patient data was stolen or a fire or flood destroyed your office?  Suppose one of your employees opened a malicious e-mail and your patient data was encrypted and held for ransom?   I know this sounds absurd, but just Google “data for ransom”.  What would be your first step?  With most medical records being stored digitally, it’s not a matter of if you’ll experience an incident regarding your electronic patient information; it’s a matter of when.
Technology is moving so fast in every industry, but in the medical industry, technology advancements are leading to more and more protected health information (PHI) theft and data breaches.   Patient information is not being properly protected. As you are well aware, protecting your patient’s confidential information is the law. Computers, laptops, e-mail, mobile devices, and thumb drives, all store and send ePHI.  Without the proper controls in place, your patient information can easily fall into the wrong hands, exposing your OMS practice to large governmental fines, and reputational risk.
HIPAA just announced that they will be conducting random audits starting in 2016.  Their pilot audit program revealed that many small to mid – size medical practices are not taking the necessary steps to protect their patient information and are not complying with even the basic HIPAA Security and Privacy Laws.   The HIPAA Security Rule now mandates that every practice take an annual risk assessment. The government also strengthened its ability to enforce the law in medical practices with fines reaching up to $50,000 per violation with a maximum $1.5 million annual penalty.  This is why Cash Flow Strategies is recommending PCIHIPAA, as a dedicated source for protecting your practice.
Cash Flow Strategies has many of our clients participating in their Compliance Program.  They have agreed to provide a complimentary HIPAA Risk Assessment (a $599 value).  You can take the Risk Assessment online and immediately receive your risk score with no further obligation.  I encourage you to take 5 to 10 minutes as soon as possible to complete the Risk Assessment  by clicking here. You’ll receive a 23- page Risk Analysis, and a 30-minute consultation that you can also schedule online.
Just click here to start your Risk Assessment.  It will be a great way to start your practice off on the right track in 2016.

GETTING MONEY FOR YOUR COMPANY OR MEDICAL/DENTAL PRACTICE HAS NEVER BEEN EASIER

9 Dec

Are you a small to mid-sized business or practice who needs fast cash to use as working capital?

Getting the money you need for your company has never been easier.  If you need $25,000 – $1,000,000, we can offer a high-quality alternative to banks.  Traditional bank loans can be sluggish, and often deserving small businesses get turned down.  That’s why we have set up a no-hassle application process to make access to working capital simple for business owners like you.

  • All credit histories considered (no minimum FICO score)
  • No complicated paperwork
  • Quick approval times (24-48 hours and even same-day)
  • Transparent Rates and Fees

Unlike banks, we don’t require a formal business plan or collateral.  If you answer yes to the following questions, you are eligible:

  1. Do you have bank statements for the past 6 months?
  2. Have you been in business for the last one year?
  3. Do you have $25,000 in gross sales per month?

In just a few easy steps, you can be on your way to a renovated facility, state-of-the-art technology, marketing and advertising campaigns that get the customers coming through your door, or any other business expense.

Don’t wait.  Call today at 770-783-9523 or 888-780-1333 to get your application started.

Cash Flow Strategies, Inc.

 

 

INSURANCE MONEY WON’T PAY YOUR BILLS ANYMORE, DOC!

16 Jun

I was told today by a doctor that he refrains from pushing too hard to collect from a patient who owes him money, because of all the money he makes on the patient from insurance companies.  He is willing to write off patient balances, to keep making insurance money from the patient visits, and doesn’t want to offend the patient into leaving the practice by insisting he pay his bill.

This is the general attitude many doctors had 25-30 years ago.  It may have had some validity back them but times have changed!  Insurance money alone will not keep your doors open and your lights on any more doc.  You are putting your practice in jeopardy by not seeing what is happening around you!

High deductible health plans are the norm these days, and co-insurance is rising all the time.  Despite what the government tells us, there are more and more patients who do not have insurance, or have adequate insurance.  Self pay is now the highest payer in the medical world behind Medicare and Medicaid, and it is catching up fast.  According to recent statistics, patient balances now represent over 35% of a doctors income and soon, if major changes aren’t made, will be over 50%.

You can’t wish it away, or ignore it away.  You MUST find a way to motivate patients to pay you, and pay you faster than before.

Medicine, whether you like or not, or understand it or not, is a business.  You are trading a service for money, and the patient knows it.  They also know when you are leaving them alone about their bill so that you can continue to collect insurance money. Not only do they know, but guess who they tell?  EVERYBODY!!!  And guess what happens?  You get all the patients who don’t want to pay their bills.  Great!  Until, that is, until you watch your patient A/R go through the roof.  By the time you see this happen, you are already in trouble.

Don’t waste time.  There are automated tools to help your practice both maintain your good relationships with your patients, AND get them to pay you their portion of the bill sooner.  Call me today at 888-780-1333 and I will tell you about them.  Isn’t it worth 20-30 minutes of your time to keep the lights on in your practice over the long haul?

Is It Time To Dismount?

5 May

My father was a wise man. He used to tell me, “If you find out that your horse has died, it is a good idea to dismount.”

I’ve found, in my experience, that many medical and dental practices are riding a dead horse, and it is definitely time to dismount.

How many things in your practice are being done the same way they were 20 years ago? 10 years? 5 years? If you are like most practices, your answer will be “nothing!” But, if you think about it, the one thing that is being done the same way it has been for a long time is the way you collect money from patients and insurance companies that owe you money.

Sending a monthly statement, and calling (when you get the time to do so) does not work any more to motivate your slow pay and delinquent patients to pay your bill. Calling, waiting on hold, and nagging insurance companies doesn’t get you paid on time either. And do you have any idea how much having employees on hold that long will cost you in a month?

Over the years, we have determined that there are four distinct types of patient payers. Each one requires a different approach to motivate them to pay you, and it is a mistake to treat all of them the same. It is hard, if not impossible, for you to determine which is which quickly and inexpensively in-house.

We have also found a much more economical and effective way to motivate the insurance companies who are dragging their feet, making excuses, and ignoring your calls to get you paid faster.

Transworld Systems can help you update and automate your A/R processes for both insurance and patients. The cost will normally be less than what you are paying now to do what you do in-house, and the results will be MUCH better than riding a “dead horse.”

Contact David Wiener at 888-780-1333 or email me at david.wiener@transworldsystems.com

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