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Receivable Management Services For Medical Providers

When it comes to managing receivables for your medical practice, a receivable management service provider can make your collections process seamless. But, how do you choose a receivable management service provider who will treat your patients with the care and compassion they deserve, while obtaining a good return on investment for their services?

Receivable Management Services Explained

Many companies provide services on credit, and expect payment after the service. The process of collecting revenue and creating terms for payment arrangements fall under receivables management. As a business grows, their collection processes need to be redefined to ensure proper protocols are being followed.

Defining Payment Terms

Define your terms of payment in clear language. Payment terms are part of your receivable management system, and should be included with invoicing for services. Let your patients know their options for repayment, and what will happen if they do not pay within the terms of your payment agreements. Define their options for making a payment, such as cash, credit, check, and where they can make a payment.

If you need assistance creating payment terms, or following up on missed payments, a reputable payment collector for medical providers can help remit payment with clear terms.

In your payment terms, let your patients know how they can make a payment via telephone or the internet. If you have an online payment portal for medical payment collections, give clear instructions for how patients can create an account and submit payment online. An accounts receivable management service provider, such as Amplicon, provides simple-to-use online payment processing that assists patients in making timely online payments for their medical accounts.

Phone Calls, Letters, and Credit Reporting

Part of the receivable management services process for healthcare professionals is reaching out to the patient and reporting their bad debts to credit bureaus. Create a method for when you will send letters, who will call the patient (your office or a company collecting debt on your behalf), and if or when their accounts will be reported to credit bureaus.  

As a healthcare provider, you are within your rights to send any medical bills to collections at any time, but the collection agency is required to wait 180 days, or six months, before reporting a medical debt on a credit report.

Insurance Claim Payment Assistance

Denied claims from insurance providers rack up for medical providers, and avoiding or correcting denied claims is a critical step in receivables management.

Common reasons a claim is denied by insurance:

  • Missing or addition information
  • Inclusions
  • Duplications
  • Deemed not medically necessary
  • Ineligible
  • Late filing
  • Incorrect ICD-10 coding

With a state-of-the-art billing and coding system and extremely skilled medical billers and coders, you can avoid most of these issues. Medical codes update on a regular basis, and your staff needs to stay up to date with changes to prevent unnecessary claims denials. Choose an electronic data interchange (EDI) system that can update automatically when medical codes are updated, and invest in continued training for all office staff for new regulations in submitting healthcare claims to insurance.

Collecting on out-of-network claims paid to patient

A Paid to Patient Insurance Claim is a healthcare claim that is physically paid out to the patient or primary subscriber of a healthcare insurance policy for services that an out of network provider billed on your behalf. Checks made out to the patient directly will start to arrive at the primary subscriber’s address from their health insurance company.

With this type of claim, the patient receives a check that is meant to be used to pay for their medical care, but often the payment does not get forwarded to the medical office requesting payment. Some medical providers will not treat patients who are out-of-network due to the low percentage of claims paid to the provider after receivable an out-of-network benefit check.

Verifying insurance prior to treatment and requiring upfront payment in these situations can help drastically reduce the number of unpaid out-of-network claims for medical providers. With an integrated payment system for insurance claims and a skilled receivables management team, you can avoid costly delays in payment and sending patients to collections. Your patients will appreciate knowing their responsibilities for payment when seeking out-of-network healthcare providers. While your medical office may not want to turn patients away, it is vital to have a standardized system in place for dealing with out-of-network insurance companies who pay claims directly to the patient, instead of to the medical provider. Amplicon also provides this type of service should you be interested, see here: Paid to Patient Insurance Claim Recovery

The Importance of receivable management services in healthcare

When accounts are not appropriately managed, medical offices see an unbalanced cash flow in their organization. When you have a clearly mapped out accounts receivable process you can significantly reduce the amount of patient medical debts being sent to collections. With fewer debts in collections, your office will pay less to collections companies for recovering debt and have a higher rate of paid accounts once they are sent to collections.

What factors are important when selecting a Receivable Management Firm?

When choosing a receivable management firm for your healthcare facility, you need to consider your options and select a provider that has both your facility’s and your patient’s best interest in mind. Check the reputation of the receivable management firm, their track record for collecting payments, and their fees for services rendered in collecting payments on your behalf. Just as you practice healthcare ethically, Amplicon is committed to ethical and lawful accounts receivable management.

What data security do they use to protect your patients protected health information?

Following federal guidelines for both HIPAA and collections processes keeps your patient’s information protected and ensures you are using ethical and legal solutions in your medical payment collections process. Here at Amplicon, we implement the following data security measures to keep your practice and your patient’s safe.

  • SSAE18– AICPA’s Service Organization Control Reports
  • SAS70– Statement on Auditing Standards (SAS) No.70
  • TIA-942– Data Center
  • Tier III – Guaranteeing 99.982% availability
  • PCI DSS – Payment Card Industry Data Security
  • HIPAA-Health Insurance Portability and Accountability Act
  • IRS 1075 – Federal Tax Information Protection
  • State Data Breach Notification Laws

When choosing a receivable management company to assist your medical office or healthcare facility, please check out Amplicon’s solutions for healthcare providers.

About the Author

Nick Arroyo

I've been an entrepreneur for the last ten years. I've had unbelievable success and tremendous failures. I'm currently in the process of rising from the ashes and making a tremendous comeback. Some say it's virtually impossible, but my favorite part of the journey has always been the climb. Jack of all trades, master of none, many times better than a master of one.

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