Massachusetts Medical Society: Ensuring Revenue Collection in an Evolving Reimbursement Climate

Ensuring Revenue Collection in an Evolving Reimbursement Climate

By Jillian Pedrotty
PPRC Specialist

The evolving health care environment has changed the way physicians are reimbursed. While insurers continue to pilot new products, there has been an increase in popularity of those with low monthly premiums that place more financial responsibility on the patient, in the form of higher co-payments or deductibles. The decline in provider reimbursement and increase in high deductible plans makes it more important than ever to have policies and procedures in place that help ensure the patient’s contribution is collected at the time of service. For nonurgent office visits, consider incorporating the following suggestions:

  • Educate your staff: Each staff member should be knowledgeable about the practice’s collection policies and the importance of collecting co-payments at the time of service. This should be a team effort and all employees should be able to explain the policies to patients and be proactive about collecting payments.
  • Communicate your financial policy: When scheduling an appointment, inform patients of their financial responsibility, if possible. One way to do this is by mentioning any outstanding balances. Patients are more likely to be prepared if they have advanced knowledge of owed balances or expected co-payments or deductibles and associated practice policies for collection.
  • Verify health insurance eligibility and benefits:Checking eligibility and other patient information prior to visits is extremely important and will help to ensure there are no surprises when patients arrive.
  • Estimate patient responsibility: Staff should verify any co-payments and make sure they are collected when patients check in. When possible, estimating patients’ share after insurance will help your staff communicate financial expectations, which can ease the collection process.

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