Medical Finance: the Challenge of Getting Paid Promptly

Medical billings, collections, and finance are essential functions of nursing facilities, hospitals, and medical providers. Medicine and patient care cannot be ongoing without billing of patients and their insurance providers and collecting these payments promptly.

According to Kareo Getting Paid newsletter, medical billing and collections are an increasing complex compliance issue for medical companies. Billing monitoring, experienced staff, and electronic records and systems must be actively managed.  medicalfinance

When the business of staying on top of business receivables becomes too difficult for the provider or facility, a cost-effective solution may be to outsource these functions.

Inaccurate or incomplete claims

Most skilled nursing facilities, hospitals, and providers’ offices start with front desk staff/medical billers. These employees may have some exposure to medical billing, but many don’t. In these cases, the business must invest in training to educate employee(s) about insurance terminology and how insurers process patients’ medical bills.

As the business grows, a multi-tasking administrative team may learn to perform these tasks adequately. However, few possess the skills to evaluate billing accurately and submit error-free documents that will be readily paid by insurance companies.

Without proper preparation and attention to detail, insurance companies, Medicare, and Medicaid routinely return bills unpaid. This delays the receipt of revenues necessary to keep the business running.

Front-office controls

A business’s medical billing staff can reduce its traffic of insufficient-funds checks by employing better controls. For example, the business can offer settlement of a bill by credit card or debit card in addition to personal checks.

Although the Physicians Practice report says it’s best practice to assume that the patient has good funds in his or her bank account, many clients prefer to use electronic payments. The payment is automatically collected and isn’t subject to funds flowing through the client’s account.

Systems evaluation

Medical associations or external billing and collections practices can help skilled nursing facilities, hospitals, or physicians’ offices to become more successful at collecting money for services rendered. Associations provide a forum in which businesses can share ideas about what works for them.

In some cases, the provider’s billing and collection system is outdated, and a new, responsive system can help the business to identify collection issues earlier.

Costs and compliance

Alternatively, the engagement of an external medical billings and collections resource can free the facility, provider, or hospital to perform patient care. By outsourcing monthly bills, follow-ups, collections, and communications, the medical business can be fairly confident that it’s in compliance. Costs associated with training, employing, and supporting internal employees who perform medical billing, collections, and/or electronic health records usually decrease when the functions are outsourced.

LTC Consulting Services in New Jersey is an example of a medical billing and collections finance partner that handles these functions for medical service providers.

Care providers are sensitive to the reality that many patients experience financial difficulties or don’t understand how their insurance policies work. Arrangement of scheduled payment plans maintains goodwill and allows the patient or family to pay for services as agreed.

Engagement of an external medical finance partner can help doctors, nursing facilities, nursing homes, hospitals, or community health centers to collect these payments when due.

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