Accelerating Patient Payments

Mary Dees Griffith explains how rising healthcare costs have significantly increased collection problems for healthcare providers.

What problems/challenges are private practices and healthcare organizations facing today? 
Mary Dees Griffith. Rising healthcare costs have caused increases in health insurance rates for both companies and individuals. To reduce the cost of coverage, many are choosing consumer directed health plans (CDHPs) or high deductible health plans (HDHPs), which only begin paying the provider directly after the patient has paid for their deductible. This shift of payment burden has caused a significant change in the financial situation for most healthcare providers. According to major studies, only 50 percent of what is billed to patients by healthcare providers today is actually collected, representing patient bad debit of $45 billion to $65 billion annually.

Under traditional coverage plans, providers needed to collect little from the patient, since the insurer paid the bulk of the healthcare service cost. With today’s plans, the provider frequently sees little to no payment from the insurer and instead must bill the patient for most day-to-day healthcare service. However, since how much the patient owes can only be determined after the insurer’s network discounts have been reflected, patients are being billed by their healthcare provider, after their insurer processes their claim, adding an additional 60 to 90 days to the healthcare provider’s collection timeframe. 

What role does A-Claim play in the patient/healthcare provider process?
MDG. A-Claim is the electronic payment solution specifically designed to accelerate patient payments for healthcare providers. A-Claim utilizes secure, proprietary systems to dramatically improve revenue collection at the time of service for healthcare providers, as well as offers flexible payment options to patients, which allow the automated collection of patient financial responsibility, when it has been determined by their insurer what they owe.

Why is A-Claim the preferred partner in healthcare payments and benefits/insurance eligibility verification processing?
MDG. With the shift occurring in the way medical practices are paid for the services they provide, patient copayments, coinsurance and higher deductibles make up a growing percentage of the total volume of a practice’s accounts receivable. This trend has resulted in medical practices facing higher accounts receivable, longer collection cycles and increased write-offs.

A-Claim is one central system that provides on-line, real-time verification of patient copayments and benefits information, while allowing the collection of patient payments at the time of service with the convenience of a payment choice for the patient - credit or debit card, checking account or automated payment plan. An integrated financial tool that enables medical practices to lower accounts receivable, shorten collection cycles and reduce write-offs, A-Claim offers the highest level of on-line security available. Its technology is quick to implement and its design makes it easy to use, allowing a healthcare provider to achieve an immediate impact to their bottom line.

How does the A-Claim system work?
MDG. A-Claim delivers information electronically and immediately at patient check-in regarding copayment, coinsurance, deductible, and other pertinent benefit information, allowing the healthcare practice to estimate what portion of the balance the insurer will pay and what portion will be the patient’s responsibility. If the patient’s health plan requires a copayment, the A-Claim system collects the copayment at the time of service automatically. 

The A-Claim system enables the healthcare practice to provide the patient an estimated payment liability amount, and gives the patient a choice of their preferred payment method at the time of service. Automated payments can be collected from the patient’s debit or credit card or a checking account, and can be set up in any collection interval.

If a healthcare provider office receives insurance claim remittance data electronically, the A-Claim system can receive these files, match patient responsibility amounts against patient payment methods on file and automate the collection of the patient’s payment - without intervention from the medical practice back office staff. If the medical office receives remittances via paper, a few pieces of data from the claim remittance can be input into the A-Claim system to initiate the automated patient collection immediately or at a pre-agreed time. Automated collection of these amounts improves the practice’s cash flow and bottom line. 

Mary DeesDeses Griffith is President and COO of Preferred Health Technology, Inc, joining in 2006.