hospital bad debt

Is it time to take a fresh look at HIPAA laws and make some modern tweaks? That’s what more than 40,000 medical group practice leaders believe. Called the Medical Group Management Association (MGMA), the group is meeting up in Washington this month to take a close look at HIPAA and its future.

Among the things MGMA wants to tackle, HIPAA’s protracted transition from the 4010 to the newer 5010 and 7030 standards is a concern. Additionally, standards like the federally mandated X12 275 electronic transaction regarding patient information is still lingering in an unpublished state. According to the director of MGMA, there has yet to be any fines when it comes to non-compliant health plans that have ignored HIPAA rules, as opposed to the strict privacy and security policies that exist. Additionally, health insurers have yet to support prior authorization transactions.

Another issue is the HIPAA attachment standard which despite its availability, an insurer may still request that additional documentation be taken care of manually and faxed, or sent to the insurer through conventional means like FedEx.

To read more about the MGMA and its efforts to revise HIPAA laws, please visit https://www.healthdatamanagement.com/news/momentum-is-building-to-take-a-fresh-look-at-hipaa.

This update is by Medical Accounts Systems, a full-service healthcare revenue cycle management company providing a number of services including insurance follow up and managed care disputes, physician reimbursement, extended business office services, and more. For additional information on our services or for any questions you may have on topics such as hospital bad debt, please call 877-759-6315.

Patient financial responsibility continues to increase, comprising a greater part of healthcare revenue. With patients causing a shift in a provider’s revenue sources, hospitals and practices alike must evaluate internal patient collection strategies, so providers can collect all the revenue owed to them promptly. With that in mind, let’s take a look at two best practices to help improve the bottom line.

Implement a collection strategy that emphasizes being proactive. As soon as a patient’s medical bill is on their way to them, the provider’s revenue cycle has slowed. With recent studies suggesting providers only anticipate collecting about fifty percent of the patient balance, it is vital to take the time and ensure staff has implemented a patient collections strategy prior to the date of an appointment. There are greater odds of a patient not fulfilling their financial responsibility if patients haven’t been made aware of their bills and payment options.

Develop payment plans. It’s well-known that individuals are having difficulty paying their medical bills due to reasons such as high deductible health plans. By having payment plans in place, providers can help patients ease the financial burden. This can significantly boost the odds of receiving the balance in full if the total cost can be broken down into smaller, easier to afford payments over time.

This update is by Medical Accounts Systems, a full-service healthcare revenue cycle management company providing a number of services including insurance follow up and managed care disputes, physician reimbursement, extended business office services, and more. For additional information on our services or for any questions you may have on topics such as hospital bad debt, please call 877-759-6315.

Healthcare revenue cycle management companies must grapple with a lot of different situations and processes on a daily basis. Prior authorization, claim submissions, both of these are two examples of common things that must be addressed. Another situation that may arise is the denial of insurance. There are different ways of addressing these denials that may help streamline the process.

When an insurance denial arises, there is the option to file an informal or a formal appeal. In the case of the former, this is a relatively simple process where the insurer that made the denial is contacted via phone. If necessary, these informal appeals should be escalated to a supervisor. With formal appeals, the process is significantly more intricate. However, all managed care organizations must have a formal appeal process in place by law.

If a patient has a self-insured plan, providers may wish to contact the patient’s employer’s human resources department for additional information during the appeal. If it’s a Medicaid managed care patient, contacting Medicaid customer service or a state ombudsman can result in further information regarding the denial. For patients with commercial plans, information regarding the appeals process is available via the provider’s policy or contract with the insurer.

This update is by Medical Accounts Systems, a full-service healthcare revenue cycle management company providing a number of services including insurance follow up and managed care disputes, physician reimbursement, extended business office services, and more. For additional information on our services or for any questions you may have on topics such as hospital bad debt, please call 877-759-6315.

Due to reasons including but not limited to employers seeking ways to cut down on the cost of benefits, healthcare plans with huge deductibles and, as a consequence patient financial responsibility, are increasing. Hospitals and health systems which are accustomed to negotiating with insurance companies to receive most of the payment for services rendered are now dealing with a new payer group: consumers.

Here are a few things to be aware of regarding how consumer financial obligation affects providers’ and hospitals’ collection efforts as well as a patient being able to pay.

According to a “Trends in Healthcare Payments Fifth Annual Report” from 2014, the number of consumer payments to healthcare providers skyrocketed to nearly 200 percent during the period of 2011 to 2014. Additionally, a survey by Availity showed that in 2014, hospitals reported fewer than 35 percent of patients had the means to pay the entire amount requested at the point of service.

Collection efforts often run into roadblocks, which forces hospitals to take on bad debt. Per the American Hospital Association, all kinds of hospitals have provided just over $500 billion in care that has gone uncompensated.

One area that most provider facilities and physician practices see eye to eye on is the importance of collecting from patients prior to them leaving the business, according to another Availity report titled “The Impact of Consumerism on Provider Revenues”. Providers also largely agree when it comes to the difficulty of collecting once patients have left the office: more than eighty percent report collecting patient financial responsibility after a visit is not an easy task, per the Availity report.

To read more, please visit https://www.beckershospitalreview.com/finance/10-things-to-know-about-healthcare-collections-patient-financial-responsibility.html.

This update is by Medical Accounts Systems, a full-service healthcare revenue cycle management company providing a number of services including insurance follow up and managed care disputes, physician reimbursement, extended business office services, and more. For additional information on our services or for any questions you may have on topics such as hospital bad debt, please call 877-759-6315.

Hiring for a revenue cycle management team can be difficult. You might not know what potential candidates are looking for in an employer. To help you out, we complied a small list of tips for hiring and attracting potential candidates.

Lots of revenue cycle management teams look for potential candidates with specific degrees in healthcare management or healthcare administration. They’re also looking for people who are proficient in healthcare programs like Epic, Meditech, and Cerner. However, you should broaden your search and teach your hires the healthcare software instead. Looking more broadly can help you find a great candidate, even if they don’t have the specific degree you want.

Lateral growth in a company is important for revenue cycle workers. Cross-training and continuing education can really help attract a candidate. A revenue cycle worker might appreciate the opportunity to learn billing or coding.

Social media is a great way to get your healthcare entity in front of potential candidates. There’s a lot of fresh graduates who are social media savvy. Social media canalso  help boost the perception of your healthcare entity as well.

Your revenue cycle management team needs great people, and you can find them by following these tips.

This update is by Medical Accounts Systems, a full-service healthcare revenue cycle management company providing a number of services including insurance follow up and managed care disputes, physician reimbursement, extended business office services, and more. For additional information on our services or for any questions you may have on topics such as hospital bad debt, please call 877-759-6315.