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Data Filing and Dollar Collection: How to enhance your front-end payment collection process

Two weeks ago, we discussed general RTE optimization with Epic. Today, we will be doing a deeper dive into RTE and how it can impact front-end payment collection.

Over the past several years, we have seen a definite trend in insurance plans that require higher up-front patient responsibility. In their 2017 Revenue Cycle Management survey Black Book found that “since 2015, patients experienced a 29.4 percent increase in deductible and out-of-pocket maximum costs on average.” More than ever, it is necessary to design repeatable and efficient processes to collect patient payments prior to service. High performers collect around 2% of daily revenue on the front end so maximizing these processes can have a huge impact on both cash and AR days.  

Below we will outline several key areas of focus to help you transform your organization into a payment collecting machine.

  1. Standardize and Automate Filing of Benefits Information – The first step in collecting payments is getting accurate payment data to your end users. Most Real Time Eligibility vendors will offer a service that standardizes the benefits data so that getting it into your EMR in a consistent format is easier. Doing this is a critical first step in automating and improving your payment collection process. Since it often-times requires high IT input, they will need to be an integral part of this process. Projects like this can take up to 6 months so it is critical to plan out timelines and resources far in advance.
  1. Integrate Data with Patient Estimation Tools – Whether you have a standalone patient estimate tool or it is integrated into your EMR, the next critical step is making sure that the benefits data you are now receiving and filing can be used by your patient estimate tool to generate accurate estimates. As part of your benefits data filing project, make sure that data elements that are used in generating estimates (deductible, coinsurance, max OOP, etc.) are filing accurately and automatically. Up-to-date benefits data is a critical component to generating accurate estimates and often these two projects will be done together to maximize the benefit.
  1. Update Payment Collection Processes – Now that the data is in your system, the most important part is maximizing your opportunity to collect. At a minimum you should be doing the following:
    • Online payment portals – Patients should be able to log into a portal and pay a previous balance or an upcoming copay.
    • Patient generated estimates – Patients should be able to generate estimates for an upcoming visit or should have a standalone tool to “price-shop” on certain services. They should also be able to pay for those services in one workflow.
    • Updated end user scripting – Now that more benefits information will be available, end users will need to be coached on how to collect on expected patient payments. Create training and scripting to cut down on difficult conversations on asking patients for payment for upcoming services.

The above items are a great starting point for enhancing your payment collection processes. If any of the above is on your list of projects for the future, reach out to us to see how we can help. We have experience in project scoping as well as execution and would love to help. Please reach out to Matt Perron and Freeman Jenkins.