5-Step Protocol to Increase Patient Collections

5-Step Protocol to Increase

Patient Collections

5-Step Protocol to Increase Patient Collections

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Table of Contents Introduction

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Patient Payments & Insurance Reimbursements

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Step 1- Collect Insurance Details

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Step 2 - Verify Insurance Eligibility

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Step 3 - Train Staff & Educate Patients

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Step 4 - Streamline Payment & Billing Process

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Step 5 - Follow-up and Track Everything

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Key Takeaways

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Introduction Maximizing patient collections is key to the success of a chiropractic practice. It is an important component of revenue cycle management. Collecting patient balances might be easier said than done as the cost of healthcare is rising and the patient financial responsibility that is growing with it.

In a recent report, 67% of providers said that their primary revenue cycle concern is patient receivables (Provider Healthcare Payments Survey 2018).

Only 12% of practices collect outstanding balances at the time of service, while some practices collect nothing at all 67% of the time.

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A study found that healthcare providers only expect to collect 50-70 percent of a patient’s balance after a visit. 70 percent of providers stated that it takes at least a month to receive payments from patients.

70%

Providers say it takes a month to collect payments from patients.

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Patient Payments and Insurance Reimbursements The key drivers of the revenue cycle for most chiropractic practices are the reimbursement of covered services from insurance payers and copays and coinsurance collections from patients. The more efficient the practice’s billing process, the more profitable the business will be.

In the past, billing teams in practices used to rely more on reimbursements from insurance companies for improving their revenue numbers.

Now, with the increase in patient responsibility, practices are focusing on collecting copayments and coinsurance at the time of service. www.zhealthsoftware.com

5-Step Protocol to Increase Patient Collections

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CMS found that 90 percent of the 12.7 million consumers in the health insurance program selected a high-deductible plan because they often offer lower monthly premiums, but have more out-of-pocket expenses for services. As the share of contribution from patients has been increasing in recent years, practices need to adopt strategies to enhance the way they collect patient responsibility.

Did you know?

Did you know?

Patient billing responsibility has risen 255% since 2006.

It costs 4 times more to collect from a patient than from an insurance company.

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The percentage of payments a healthcare provider collects decreases with every day that the bill is past due.

This means practices need to equally monitor insurance claims and patient

95%

The percentage of people who fail to fully pay off patient balances is expected to climb to 95% by 2020, according to TransUnion Healthcare.

collections to shorten the revenue cycle.

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5-Step Protocol to Increase Patient Collections

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Chiropractic practices must implement an effective payment collection protocol to avoid losing out on much-needed revenue. To improve your rate of patient collections, it’s time to restructure your revenue cycle management process and implement this 5-step protocol to collect more and reduce outstanding patient balances.

2. Verify Insurance Eligibility

3. Train Your Practice Staff

1. Collect Insurance Details

4. Streamline Billing Process

4. Follow-Up and Communicate 09

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Step 1 - Collect Insurance Details When a new patient books an appointment, it’s crucial to collect updated and complete information about his or her insurance details and demographics.

Use the below checklist to collect patient’s insurance information:

5-Step Protocol to Increase Patient Collections

1. Patient name and DOB

6. Insurance plan

2. Patient’s address

7. Member ID

3. Patient mobile number

8. Group ID number

4. Social security number

9. Copay or coinsurance

5. Insurance company

10. Relation to Insured

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Don’t forget to ask about secondary or tertiary insurance! If the patient has other policies, your staff will need to gather all of the above information for other policies as well.

For established or existing patients, make sure their insurance details are up to date in your chiropractic EHR software. Ideally, new and returning patients bring their insurance cards when they come to your practice. Or you can call the patients to collect insurance details after they book an appointment with your practice.

Once you have patient insurance details for a patient, your staff needs to check if the information is correct. Move ahead to the next step to verify the patient’s insurance information.

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Step 2 - Verify Insurance Eligibility Checking a patient’s insurance eligibility and benefits is essential to your practice income and productivity. Your staff can perform eligibility checks in several ways depending on the processes you follow in your practice. To verify information, you can follow one of these methods:

Method 1 - Check the website of the insurance carrier to verify if the information on the patient’s insurance card is up-to-date and correct.

Method 2 - If you have hired managed billing services, the company can check patient insurance eligibility on your behalf. This will save you time and effort.

Method 3 - Call the insurance representative directly. When you have the payer rep on the line, make sure to ask these questions and gather crucial information:

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Questions to Ask for Insurance Eligibility Verification Q: Can you confirm the patient’s policy and group number?

Q: Can you confirm the name of the insurance holder Q: What is the relation of the insured to the patient?

Q: Can you confirm if the patient’s insurance plan is active, and if so, what is its end date?

Q: How many visits does the patient have left this year?

Q: Can you confirm your claims address?

Q: What is the patient’s copay and/or coinsurance?

Q: What is the patient’s deductible?

Q: Do you require pre-authorizations or physician referrals?

Q: Are there any coverage limitations?

Q: Is our provider in- or out-of-network?

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9 out of 10 patients want to know their payment responsibility upfront.

The ability of a practice to successfully train staff on the financial health of the practice has a positive impact on the revenue stream.

To overcome the challenges with patient collections, it is important for the biller and office manager to review the current account receivable trends in your practice identify the collection opportunities in the practice. Chiropractic billing software not only streamlines the billing process but also helps your staff to generate A/R, payment, and patient balance reports for a better understanding of the current financial health of the practice.

5-Step Protocol to Increase Patient Collections

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Step 3 - Train Your Staff & Educate Patients

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demographic and insurance information. Trained staff will know how to communicate the financial responsibility of the patient based on the services rendered while maintaining positive patient relationships.

When your staff tells your patients exactly how much they will owe for their care prior to treatment, this will remove uncertainty and increase the chances of collecting patient balance at the time of service.

When your staff has verified the accuracy of a patient’s insurance information, it is better to let the patient know what they’re expected to pay after the treatment. This will help you avoid any unhappy surprises.

5-Step Protocol to Increase Patient Collections

The front-desk staff needs to have the knowledge and skills to collect accurate patient

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Step 4 - Streamline the Payment & Billing Process Providers may be able to collect more patient revenue and improve patients’ financial experience by implementing a streamlined payment and billing process. Here are several ways that will help chiropractic practices to collect more patient balances:

a. Accept multiple payment methods Increase the likelihood of collecting balances at the time of service by offering a variety of payment methods, including cash, credit/debit card, or check.

b. Offer an online payment option

Empower your patients by providing an online portal where they can pay their bills at their own convenience. Offering an online payment option will help your practice increase collections and give patients peace of mind that they can pay for the treatments when they want.

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c. Start using Chiropractic Billing Software Chiropractic billing software will help your practice easily manage the challenges that come with billing insurance. With accurate charge capture, advanced claim processing, and billing analytics tools, your practice can stay on top of your patient A/R.

d. Implement a credit card on file policy Instating a credit card on a patient’s file that requires patients to leave their payment information with your practice ensures that you get paid at the time of service.

Step 5 - Follow-up and Track Everything a. Provide electronic patient statements The patient follow-up process should go beyond traditional communication. Send electronic patient statements and information to the patient/insured person to effectively convey the balance due for chiropractic services.

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According to a 2019 McKinsey and Company report, 50% of patients want more clarity from their bills. By sending electronic patient statements, you can accelerate cash flow, lower your costs, while providing greater convenience to your patients.

71%

71% of consumers to enroll in eStatements from providers (Consumer Healthcare Payments Survey 2018)

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The patient eStatement should include pertinent information regarding: 1. The provider of services, 2. Services performed, 3. Charges of services, 4. Payer payments and adjustments, and 5. Contact name, address and phone number for statement inquiries There is a higher chance of getting a patient to respond to balance dues if they understand what services were performed, how much they owe, and how to pay or inquire if they have statement queries.

Chiropractic EHR and billing software makes it easy to generate electronic patient statements and send them to patients via email. With zHealthEHR’s cloud-based billing software, you can prepare on-demand patient statements if you would like to provide a patient with a walk-out statement or if you would like to send a patient their latest statement in response to balance inquiries.

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b. Patient Follow-ups While chiropractic practices ideally should work to receive payment from patients at the point of care, sometimes this is not possible. Therefore, it is important to implement an effective plan for the collection of payment after the patient has left the practice.

Develop a proactive plan for contacting patients who have not made timely payments.

Create a script for your staff to follow. Your staff should be able to communicate effectively on how to request payment in full, discuss payment options, and offer a payment plan if needed.

Add a follow-up reminder in your chiropractic EHR for collecting patient balances the next time the patient visits your practice.

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c. Track the Financial Health Tracking and managing the financial health of your practice is important. Make reviewing your payment collections a standard part of your regular financial tracking process. To drive improvement in patient payment collections, it’s essential to track and manage your results.

Start tracking these reports and take measures to improve your collections: Accounts Receivable A/R Report This is a great tool for measuring the overall financial health of a practice. The A/R report breaks down money owed from patients and insurance payers based on the number of days they’ve been in receivables.

Red flag: Claims that take longer than 45 days to process. If the days in A/R is more than 90 days, it is an even bigger red flag.

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Money Collected or Received Report This report will show information about how much you have billed and collected from patients and insurance companies. You will get a clear idea of how much you should collect from your patients to pay their claims.

Patient Payment Report Another vital set of reports that your practice needs to analyze are patient payments.

Tracking patient payments is essential to ensure that your practice is profitable. In this report, you should be able to track patient name, patient type, payment method, and amount paid.

Patient Active Credit Report A credit report can show if the patient has a long history of not paying his or her payments or which patients to approach first to collect payments. You can start communicating with patients who have more balances on their accounts. Check the patient profiles with high balances to know how much you should collect from them.

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Sukhi Singh, CEO and Co-Founder of zHealthEHR

Revenue cycle management needs to be integrated with other activities around patient experience. Providers need digital tools like chiropractic EHR and billing software to engage patients and provide exceptional experiences.

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Key Takeaways

To improve patient payment collections, chiropractic practices may want to consider:

• Ensuring accurate insurance and contact information is collected.

• Verifying insurance eligibility before the time of service.

• Simplifying billing process with chiropractic billing software.

• Providing electronic payment methods to patients.

• Training staff on how to communicate and deal with patient collections.

• Educating patients about the changing environment of financial responsibility.

• Tracking collections on a weekly or monthly basis to monitor and improve financial health.

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About zHealthEHR zHealthEHR is specifically developed for chiropractic practices. We provide EHR and chiropractic practice management software needed to build a successful and profitable practice. Our software is an all-in-one solution with a diverse range of tools including EHR, Billing, Practice Management, Review Automation, Telehealth, and Patient Recall. And for those looking for extra support, zHealth offers managed billing services. For more info, visit www.zhealthsoftware.com

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