by Nels Peterson
Third party billers focus on coding and compliance for good reason. Public and private payer requirements make receiving a timely and correct reimbursement for their customers a challenge. Add the prospect of penalties or even criminal allegations from either payers or regulatory agencies and the reason is clear. This focus highlights the third-party biller’s value proposition of cutting costs, risks and liabilities for providers. However, with the current shift to self-pay patients in today’s healthcare environment, a third-party biller’s traditional emphasis on coding and compliance ignores the main patient communication vehicle for the revenue cycle — the patient statement.
Catastrophic insurance policies with high deductibles and the uninsured have combined to increase the number of self-pay patients. HFMA’s November 2009 Research Findings regarding the shift to self-payment found that 97% of provider respondents experienced an increase in self-pay accounts receivables from the prior year. In a third of the respondents, this self-pay account receivable growth resulted in receivable balances growing faster than patient revenue. These numbers highlight the increasing value of the patient statement to providers and their third-party billing partners.
The statement is the final ‘patient touch’ experience with the provider. It gives the patient an opportunity to garner a first-hand impression of the provider’s revenue cycle. How good is the financial communications vehicle you send for your customers? The HFMA Patient Friendly Billing Project exposed patient billing as a significant problem for patients and providers. This project is based on the ideal that the patient statement should be easily understood by the average reader.
Is your statement intuitive from a patient’s perspective? Who’s it from? How much do I owe? What’s my account number? What’s that code mean? I need my readers? This font’s too small. These are all examples of patient frustration with the bill received. Healthcare terminology can be an unknown. Codes and acronyms that professional billers take for granted mean nothing to others.
Is your statement an effective collections vehicle? Is the amount owed obvious? Is there a due date for payment? Do aging buckets help collection efforts by demonstrating days overdue or hinder those efforts by demonstrating probable lack of action for 90 or 120 days? Can medical providers expect the same prompt payment that credit card companies do? Providers and medical billers are forced to ask questions like these as they seek to become more aggressive in their collection efforts.
Addressing these issues can affect important metrics for you and your client.
The number and length of inbound calls to your call center staff can be decreased, the number of statement complaints and patient correspondence received can be reduced and the amount of self-pay receivables can be lowered. These improvements could be addressed without involving changes to your medical software.
When’s the last time you re-evaluated the patient statement your company’s providing? The increasing value of the patient statement demands it. At the very least it would take an investment of time to assess the need for improvement. But the end result will demonstrate your commitment to being the proactive management services partner your customer hired.
