The Good:

1. Efficiency: Billing software can significantly increase efficiency by automating repetitive tasks, such as data entry and invoice generation. This can save time and reduce the risk of human error.
2. Accuracy: Modern billing software is designed to be highly accurate, reducing the likelihood of billing errors that can lead to financial disputes or regulatory issues.
3. Cost Reduction: Using billing software can reduce the need for extensive manual labor, leading to cost savings in terms of employee salaries and operational expenses.
4. Data Security: Good billing software often includes robust security features to protect sensitive financial data from breaches and cyberattacks.
5. Analytics and Reporting: Many billing software solutions come with built-in analytics and reporting tools, allowing companies to gain insights into their financial performance and make data-driven decisions.

The Bad:

1. Cost of Implementation: Implementing billing software can be expensive, including the initial purchase cost, training, and potential customization to fit the company’s specific needs.
2. Learning Curve: Billing software can be complex, and employees may require training to use it effectively. This learning curve can lead to temporary disruptions in operations.
3. Dependency on Technology: Relying heavily on technology can be risky if there are system failures, technical glitches, or if the software becomes outdated.
4. Security Concerns: While billing software can enhance security, it can also be vulnerable to hacking and data breaches if not properly protected and maintained.
5. Lack of Customization: Some billing software may not fully meet a company’s unique requirements, necessitating additional development or workarounds.

Regarding the billing company’s usage of the software, it’s crucial for them to:

• Understand the Software: The billing company should have a thorough understanding of the software’s capabilities and limitations to maximize its benefits.
• Employee Training: Adequate training programs should be in place to ensure that employees are proficient in using the software efficiently and securely.
• Procedures and Compliance: The billing company must establish procedures that align with industry regulations and best practices to ensure compliance when using the software.
• Regular Updates: Keeping the software up to date is crucial for security and taking advantage of new features or improvements.
• Data Backup and Recovery: Robust backup and recovery procedures should be in place to protect against data loss.

In conclusion, while billing software offers numerous advantages, it’s essential for billing companies to carefully consider both the advantages and disadvantages and take steps to mitigate potential pitfalls. Proper education, training, and procedural safeguards are crucial for harnessing the full potential of technology in billing operations while minimizing risks. Fortunately, Merem Healthcare Solutions encompasses ways to mitigate both the bad and good in technology, so you don’t have to worry about anything related to your revenue cycle management operations.

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Collecting new deductible payments for medical services up front can be uncomfortable,  but it is something that needs to occur for the cash flow within your medical practice to be moving in the right direction. With many patients’ deductibles starting over at the beginning of the year, the team at Merem Healthcare Solutions wants you to understand just how important it is for the front office of your medical practice to take payment when signing in a patient at your practice.

Handling the Collection Process from the Start

The goal of your medical practice is to provide high-quality, healthcare services in a caring and comfortable environment. In order to do so while offering state-of-the-art equipment as well as pay for experienced team members, you need to have a positive cash flow happening within your medical practice.

Let’s take a look at three ways your medical office can efficiently handle patients’ deductible collections upfront without sacrificing quality care or seeming “uncaring” by patients.

Establish a Collection Policy

One of the best ways to increase cash flow for your medical practice in the new year is through establishing a collection policy for your office so that all patients are aware of what is expected upon their arrival. This collection policy will not only help your patients but also your front office staff so that it is seen as just that – policy – and not of team members lacking sensitivity toward patients.

While there are other avenues in which medical practices receive funding, such as insurance companies, a patient’s payment does make-up a good amount of the overall total. A collection policy can assist medical practices in avoiding non-payment by patients who visit for medical care.

Train Front Office Staff Appropriately

While it might be beneficial to train all medical team members on how to properly accept payments from patients, it is definitely wise to ensure optimal training is given to front office team members, especially since they are the first person a patient sees and the person most likely to be asking for/collecting payments.

Train your front office team members on

1. How to handle requests for payment.
2. And, what to do should a patient become angry about needing to pay upfront.

In addition, it might be best practice to teach front office team members on giving patients a heads’ up during reminder calls on how much will be due at the time of arrival. This way the patient is already notified and aware of how much the office visit will be when they come for their appointment.

Consider Offering Financial Assistance

Chances are high that your specialty medical practice sees uninsured and underinsured patients. Therefore, your medical practice should consider offering financial assistance to those patients who qualify, especially since this program can help both you and the patient.

For most specialties, offering a financial assistance program, such as Care Credit, from the beginning of treatment is a lot easier to collect payments rather than trying to get financial assistance for a patient after he or she has already been treated. As a result, your medical practice could end-up not receiving payment at all.

Merem Healthcare Solutions offers services for every step in a practice’s revenue cycle management. We can start from the beginning from credentialing and end with payment posting once an account has been satisfied. We offer a wide range of solutions which include auditing, billing, coding, consulting, credentialing, payment posting, practice management, and patient pre-collections training. Check us out on our website or feel free to call us to see how we can help run your practice like a well-oiled machine – (205) 329-7519.

The post New Year, New Deductible Collections! appeared first on MEREM Health.

From Cardiology to Orthopedics, Dermatology or Pain Management, if a patient has a poor visit at your medical practice, he or she is going to be less likely to make a payment once the bill is received. Rather than receiving the bill and turning a payment around in a quick manner, a negative patient experience can often lead to them just sitting on the bill and paying late – if at all. A negative visit is linked to a delay in payment time.

This payment process doesn’t do you, or even the patient, any favors, which is why it is important to consider outsourcing your medical practice’s billing so that your medical team can pay more attention to what is really important, which is the patient and his or her health.

Put Your Focus Back on Patient Experience

There is a huge correlation between patient satisfaction and the patient paying their medical bill upon receiving it in the mail. As a result, the medical billing team at MEREM Healthcare Solutions has found that medical practices can become more profitable when they come together to work on patient care with a third-party that is focused on billing and collections.

When the patient arrives at your medical facility, he or she needs to feel as though they are the only patient in the room. From the moment the patient signs in, to the moment the patient leaves the practice, he or she needs to feel like their overall health was the priority.

Yet, if the front desk receptionist is more focused on getting the patient’s payment rather than what he or she is there for, it can start the vicious cycle of a patient having a poor experience.  But, if a third party was involved in taking care of payments, then the patient could receive the quality care from the moment he or she walked through the door because the front desk receptionist could focus more on the patient and why he or she is there, rather than on payment collection.

It Is All Perception

Now, it is not to say that when your medical team is handling billing, too, that your staff doesn’t care about the patients. But, from a patient’s view, it can come off that way, especially if he or she is sick, tired, frustrated, etc.

By taking this one step off your plate, you not only take stress off your medical team so that they can focus solely on patient care, but you are also opening the eyes of patients to see themselves as more than just a payment to your practice.

Merem Healthcare Solutions offers services for every step in a practice’s revenue cycle management. We can start from the beginning from credentialing and end with payment posting once an account has been satisfied. We offer a wide range of solutions which include auditing, billing, coding, consulting, credentialing, payment posting, practice management, and pre-collections training.  Check us out on our website or feel free to call us so see how we can help run your practice like a well-oiled machine – (205) 329-7519.

The post Positive Patient Experience = Timely Payment appeared first on MEREM Health.

Managing your practice’s revenue cycle requires an honest look at your current workflow. From front office pre-collections to denials management, MEREM Health wants to help you determine what is working and what isn’t by offering a Free Revenue Cycle Audit. Before you proceed, there are 5 practical questions you should answer to better prepare for your next revenue cycle assessment.

1. Do your patients know that their payments are due before the come in to see you?

Are your front office staff aware of and clearly communicating the patient’s financial obligations or are you assuming that patients know what is due? Check to make sure your policy is listed on your website and on all billing statements to make sure they get it.

2. Are you checking your Collections Report daily?

Like the speedometer in your favorite car, you’ve got to keep a watchful eye on your daily collections to ensure that revenue loss isn’t stacking up daily. Your investment of time in making collections monitoring a daily practice will help you to quickly see

• how many patients were seen that day
• how much money was collected
• how many patients were collected from

If a patient wasn’t collected from, your report should also explain why that occurred. This will be useful tool in keeping your front office staff accountable.

3. How do you hold your front desk accountable and what measurable performance do you review?

Pre-Collections are just a part of their many responsibilities. Make sure that your front desk staff are accurate in collecting patient information, reviewing and collecting patient deductibles, copays, and past due balances. Also, be sure to look at their preauthorization efforts in comparison to claims denial causes.

4. Have you invested in technology and continuing education?

In order to have the most efficient billing process, your technology must be up to date. EMR, scheduling programs, and medical billing software can make a big impact on streamlining your practice’s financials and workflow.

Also, ongoing training for your staff is a timely but beneficial investment to ensure they are properly trained and up to date on all policy changes and are knowledgeable of filing deadlines.

5. What are your KPIs and how are they performing?

Comparing monthly reports can provide a clear indication of existing data trends. Monthly reporting does a great job of showcasing your monthly spending, which is important for budgeting in the present, but it does not do a proficient job of illustrating trends and overall revenue cycle performance. Custom Reporting is a great asset to collect and evaluate trending data.

If you do not monitor your monthly reporting, months can go by and many practice owners have no idea whether their practice has grown or at least maintained and balanced their revenue. A monthly dashboard with custom performance metrics is invaluable. [For More Information…]

MEREM Healthcare Solutions offers a FREE Revenue Cycle Audit and Practice Consultation Solutions for specialty clinicians, groups and healthcare entities. We deliver custom healthcare solutions to help you better understand your practice performance. If you are in need of consulting services for your medical practice or would like a revenue cycle audit performed, Request a Free Consultation with MEREM Health today.  For more information, call (205) 329-7519.

The post Five Practical Questions to Answer Before Your Next Revenue Cycle Assessment appeared first on MEREM Health.

What you may not know is, healthcare providers must follow and provide evidence of conservative care; which takes time, patience, and multiple doctor visits to determine and support a diagnosis.

Our Observation:

Patients need patience and providers must clearly communicate their methods.

Before you seek out to find more attentive care, take time to talk with your physician… and keep in mind, that doctor hopping could cost you more time, and a lot more money.

New patients incur a bill based on the fee schedule for their 1st visit as well as any specific codes used to apply billing charges based on their appointment. They are determined not only by the type of provider you see, the classification of your visit, and the procedures provided, but fees are also applied for new patients at a different rate than returning patients.

While your medical records may follow you from doctor to doctor, the billing cycle as a new patient restarts every time you seek out a new healthcare provider.

Your Medical Billing Briefly Explained

As an outsourced billing solution, MEREM Healthcare Solutions delivers medical bills to patients and we also receive patient calls regarding those medical bills. Patients often request that we review and explain the charges that appear on the billing statement and the difference in costs on the EOB (explanation of benefits). Anytime your insurance has been filed, you should receive an EOB from your insurance company that explains

1. What your insurance paid
2. What was adjusted (contractual obligations)
3. What the patient responsibility remains

Image Source: https://www.wellmark.com/insurance-explained/your-benefits-in-action/how-to-read-your-eob

Looking at your EOB

For any consumer confused by the list of charges on your EOB and the possible difference in charges on your medical bill, you may not be fully aware of the contractual obligations between your provider and insurance company. Gaining a better understanding of a Fee Schedule and Contractual Obligation for yourself and from a provider perspective, may help.

A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers. This comprehensive listing of fee maximums is used to reimburse a physician and/or other providers on a fee-for-service basis. CMS develop fee schedules for physicians, ambulance services, clinical laboratory services, and durable medical equipment, prosthetics, orthotics, and supplies.

Contractual Obligation is the portion of the reimbursement from a payor that the provider cannot contractually expect payment for and cannot bill the patient for. It’s referred to as a “write-off” amount above the Allowed Amount or usual and customary rate.

For example, an office visit occurs and the provider bills the patient’s insurance or Medicare $100. The insurance company (or payor) has a set amount they’ve determined is appropriate compensation for that service. Maybe $60. The additional $40 charged to the payor is denied as Contractual Obligation with a remark code indicating that is the reason for denial. Then, depending on the policy, they (insurance company or Medicare) will pay all or part of the $60 and whatever portion is patient share will come out of that $60 as well. An 80/20 policy like Medicare would pay $48 and “deny” $12 as patient responsibility (coinsurance) and the provider would then bill $12 to the patient but NOT the additional $40 denied as Contractual Obligation.

Providers are subjected to fee schedules in order to regulate the cost of healthcare. The contractual obligations also known as adjustments, identify the difference in costs that providers are allowed to bill patients.

Our Observation:

Understanding financial responsibilities as a patient can relieve frustration and confusion after your office visit or procedure.

To avoid further frustration and confusion of your patient responsibility, there are 3 areas you as a consumer need to look for to better understand what your bill means.

• Deductible – patient responsibility owed before insurance will cover charges
• Co-insurance – the splitting of cost among insurance and patient (Usually 80/20 ratio of insurance covered, and patient cost owed after your deductible.)
• Co-payments – the sole patient responsibility that is due at the time of service

The expert billing team at MEREM Healthcare Solutions is the primary point of contact for a patient’s statement and payment plan questions. Patients appreciate having their phone calls received directly by one of our U.S. based billing team members in our patient call center.

The post Two Observations For Patients, That Providers May Not Tell You appeared first on MEREM Health.

Optimizing Patient Collections

Long gone are the days of $25 co-pays and $250 deductibles. With the increasing prevalence of high deductible insurance and patient cost-sharing plans, it has never been more important to the financial health of your practice to have an efficient patient pre-collections program in place. Less than 50% of these up front balances are ever recovered, placing a great burden directly on a clinic’s revenue due to “bad debt.”

At this year’s mid-year mark, can your practice afford your current record of unpaid bills in write-offs?

3 Steps Toward Optimizing Patient Collections

Clinical staff play a key role in patient collections. At Merem Healthcare Solutions, we work with our client partners to develop a Patient “Pre-Collections” strategy that is both aggressive and fair. Following these three tips will help your clinical staff to develop a Point-of-Service (POS) collections process to effectively collect more money up-front.

1. Constantly update a record of unpaid bills and review it with upcoming appointments.

Typical patient collection efforts only go as far as issuing statements and generating “bad debt” reports of accounts that need to be turned over to collections.

We can provide you with custom reports such as a payment plan list, to aid in POS collection efforts and to ensure patients meet their terms

2. Clearly communicate with your patients that outstanding bills are expected to be paid prior to their clinic visit.

When you can discuss these matters prior to the procedure date, patients are more likely to be receptive and proactive rather than distracted or caught off guard and agitated about any unexpected financial obligations. Also, you will help patients to better prepare financially for their visit and open the opportunity to provide payment options prior to sending to collections.

With MEREM Health, you will have the added support of a patient collections representative to support your billing team. Our patient collections reps work diligently to collect patient balances in full or to make payment arrangements within 90 days and will help you identify and transmit delinquent accounts to a third-party collections agency of your choice.

3. Train your clinic staff to prompt the patient for payment

This is a guaranteed technique in the effort to increase practice revenue but it requires a strategic and passionate approach. As you inform patients’ preemptively of what they will owe for their care, the more likely you are to get paid.

Discussion of a patient’s financial obligation should begin prior to receiving treatment. Many consumers lack a clear understanding of their insurance coverages and are often unable to determine their financial responsibilities themselves.

Keep explanations simple in order to help ensure patients understand what is expected of them and help avoid confusion or discourage them from listening to or reading information. Also, be sure your staff are prepared and available to answer any questions.

For more information about our Patient Pre Collections Services, visit our website. www.MEREMHealth.com

MEREM Healthcare Solutions is a Birmingham, AL-based company that has been providing exceptional medical billing and coding services to physician practices and ambulatory surgical centers since 2008. We pride ourselves on not just maintaining, but exceeding, the level of accountability, communication, and customer service that is valued in traditional, on-site billing departments.

Please check out our other blog posts, or contact us to learn more.

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