One of the big challenges many doctors face is finding ways to grow medical practice collections.
In most businesses, collecting payment from a customer before delivering the good or service is completely logical. In medicine this is the reverse. The doctor sees the patient first, then a claim is filed or payment is collected as the patient leaves.
For this reason, many physicians find themselves under constant pressure to get paid for the work they do. Finding methods to grow medical practice collections can become a real headache.
The creation of the Affordable Care Act in 2010 (also known as Obamacare) shifted reimbursement models from the fee-for-service models to a value-based payment modules. With the changes coming to Federal Government in 2017 (informally known as Trumpcare) there may be a shift again in new directions. However these changes remains to be seen.
According to Dr Sudip Bose, “It seems that the intention of the government to incentivize efficiency is noble. Yet it often leads physicians on a wild-goose chase for reimbursement.”
To grow medical practice collections, here are three important tips to follow:
1) Ensure Medical Claim Accuracy
As medical insurance claim denials are becoming more frequent, it is important to ensure correct information. Denials can take many hours to deal with, leading to increased cost, time, and frustration for the physician’s practice and the patient. To ensure medical claim accuracy, you must:
-Ensure correct spelling of a patient’s name compared with the insurance record.
-Check if the patient’s health insurance coverage has lapsed, and obtain proof of new insurance.
-Ensure the insurance claim is not missing a modifier, or that the modifier is now invalid.
-Avoid any mismatch between the actual diagnosis and the service performed leading to the appearance of a lack of medical necessity.
– Check to see if the service is covered under the patient’s insurance plan benefits.
– Ensure the claim is not missing prior authorization or missing the effective period of time within which pre-approved service must be provided for reimbursement to occur.
2) Go out of network, or fee-for-service
Another effective solution to grow medical practice collections is to leave insurance behind altogether. Some physicians have discovered that by opting out of accepting insurance, they avoid the hassles and changes resulting from healthcare reform.
These fee-for-service physicians believe that in order to best help their patients, they need the freedom to spend more time and do the required testing that will help them discover underlying causes.
A fee-for-service model would be wonderful if every doctor could follow it. The reality for some is that their entire patient base may not have the means to pay out of pocket. Therefore a mix of fee-for-service and insurance claims may be a middle ground options to help grow medical practice collections.
3) Using Telemedicine Visits as a source of income
By adding Telemedicine services in the medical practice, physicians can offer the option to virtually treat fee-for-service patients.
A Telemedicine medical patient will pay upfront for the time saving convenience of a virtual visit. In a sense they will pay extra to avoiding a trip to the doctor’s office. Telemedicine platforms now allow physicians to keep the entire payment..
Instead of opting out of avoiding of insurance completely, telemedicine allows flexibility of setting full or limited availability. This virtual doctor access is a great incentive for patients.
At the end of the day, being able to grow medical practice collections is the key to long term health of the business. Finding these methods and customizing them to suit your own medical office is key to your long term survival and success.