Take steps now to prevent revenue loss
Take steps now to prevent revenue loss
Cost-shifting continues
Regardless of whether patients are covered by a commercial carrier, an employer group, or a combination of both, new processes are needed for patient access areas, says Gail Draper, director of clinic support services at University of Utah Hospitals & Clinics in Salt Lake City.
"You're already behind the eight ball if you haven't begun," she warns. "Even with technology, non-standardization of data from the payers can still be challenging."
One plan might have no coinsurance for a service, whereas the same plan provided by a different employer does. "The cost-shifting continues to fall to the patient. It becomes a nightmare to collect on services," says Draper. "It's not just co-pays and deductibles. How do you capture co-insurance when the payer has so many variables, based on the plan and the employer?"
The provider of service is responsible if information on effective dates, termination dates, or co-pays for various services is incorrect, she adds, even if the error occurred because a system was updated late. "Healthcare reform will force many changes," says Draper. "We need to design systems and processes to help us capture the varying benefit structure that will come at us."
Collaboration needed
Registrars and financial counselors need to work as a team to handle point-of-service (POS) collections, according to Draper. "Merge the expertise of these two positions," she advises. "The necessity of a clean registration and the need to capture complicated POS collections make this a likely pair."
Staff members need to know the patient's financial history to answer billing questions and establish payment plans effectively, she says. "POS becomes crucial, especially with the small balances that will become cost-prohibitive to chase, and loss to the bottom line," adds Draper.
Technology can counter any potential revenue loss due to benefit variances and cost-sharing, adds Draper. "Information technology is vital to ensure systems are firing correctly," she says. "It may determine how you will, or will not, get paid."
Regardless of whether patients are covered by a commercial carrier, an employer group, or a combination of both, new processes are needed for patient access areas, says Gail Draper, director of clinic support services at University of Utah Hospitals & Clinics in Salt Lake City.Subscribe Now for Access
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