Should You Create a Sliding Fee Schedule for Your Practice?
Without exception, every medical practice faces issues related to patient payments. The challenges vary – ranging from patient financial hardship to lack of insurance to high deductibles, coverage gaps, and so many more.
There’s no cure-all for a practice’s patient-payment issues, but there are a number of ways administrators can try to manage them. (One is working with a trusted medical billing firm to make sure the revenue cycle moves as smoothly as possible, with as few claims mistakes gumming up the works as possible.)
One approach seeing increased interest among providers is the idea of a sliding fee schedule, which allows you to provide discounted services based on a family’s income in comparison to the Federal Poverty Guidelines. By creating such a schedule, you can offer a financial break to both low income and self-pay patients – allowing you to minimize issues related to non-paying patients.
Before using the sliding-fee model, however, you need to consider how it will affect your practice financially and how to stay compliant with applicable regulatory guidelines. Here’s a (non-exhaustive) primer on the factors to keep in mind.
3 New Strategies for Patient Acquisition
By creating a website, maintaining a Facebook page, and keeping your online contact information up-to-date, it’s fairly easy to make sure patients in need can find and reach your practice. And by supplementing those efforts with a bit of paid advertising or search-engine-optimization services, you can be more likely to stand out online compared to competing practices in your community.
But with all of those efforts above, you’re simply enhancing your ability to be found by patients when they need you, and hoping to see them pick you over your peers. That passive approach can work, but it neglects many factors that drive patients’ choices in one direction or other.
After patients find you online, why should they select your practice over others? What makes you a better option? Why should they believe in you? Deploying patient acquisition strategies designed to drive preference, trust, and value (not just awareness) can make the answers to those questions clear to prospective patients. Here are three approaches to try.
Risk Adjustment: Could Your Coding Strategy Be Hurting Your Practice?
As the healthcare industry moves away from the traditional fee-for-service model and over to an increasingly value-based landscape, the role of coding is becoming more important than ever. And you don’t need to take our word for it; some high-level folks in the government are speaking a lot louder than we are:
“The coding industry is at the heart of how we establish value,” said Mike Leavitt, former governor of Utah and former secretary of Health and Human Services, at the recent HEALTHCON 2017 event. “There will be an enhanced need to figure out who is doing a good job. That’s going to require coding in some form and in some way.”
Leavitt’s words are worth listening to. How well, and how accurately, you code for your services will ultimately affect your ability to comply with value-based care programs. If you don’t pay heed to your coding strategy as part of your work with a medical billing firm or in-house revenue cycle team, you’ll lessen your odds of earning incentives… ultimately hurting your bottom line.
Worse, the wrong approach to coding can attract the wrong attention. For example, the Justice Department currently has a federal lawsuit against UnitedHealth Group – the nation's largest Medicare Advantage (MA) insurer – for inappropriately coding medical claims for financial gain.
5 Reasons Why a Medical Billing Firm is Your Practice’s Best Ally
As for any thriving business, your in-house people are your practice’s best asset. But no matter how talented and capable your personnel may be, they’re not enough to help your medical office navigate the ever-changing landscape of the healthcare industry.
Every practice needs an ally for maintaining their financial health. And while tech companies and consultants may claim that they have the cure to what’s ailing your revenue cycle or cash flow, only a trusted medical billing service can deliver the following benefits to your medical practice.Stability That Scales
No matter your practice’s size, relying on an in-house billing team can lead to revenue interruptions related to employee absences or staffing changes. And as payers get pickier about claim filing deadlines, you can’t afford to let vacations and resignations damage your ability to maintain financial health as (or if) your practice grows to serve a larger patient base.
EHR Implementations: What Works? What Doesn’t?
In 2017, some medical practices have more experience with EHR implementations than they’d care to. After first deploying solutions around the dawn of Meaningful Use (circa 2011), many have moved on from their initial selections.
Nowadays, most EHR implementations aren’t about onboarding a practice to a digital solutions from scratch, but rather about replacing their first choice of EHR – or even re-replacing their second choice of EHR – for a better solution. But when it comes to the actual implementation process, practices that fail to heed the lessons of earlier deployments are doomed to repeat their mistakes.
Net Collection Rate: Understanding Your Practice’s Most Important Metric
For physician practices and their medical billing firms, net collection rate has always been a metric with huge implications for financial success. But in today’s healthcare environment, it’s more important than ever before.
Which Medical Billing Metrics Should You Measure? 5 KPIs for Your Practice
In a recent post, we called the net collection rate your practice’s most important metric. And we stand by it!
Since the net collection rate measures just how much money you receive against funds owed for services rendered, it speaks to the success of nearly every aspect of your practice.
3 Tips for Minimizing Your Medical Practice’s Cybercrime Risks
Security-, privacy-, and cybercrime-related concerns are especially problematic for medical practices. In the event of a breach or data theft, it’s not just the healthcare organization that gets affected – it’s potentially every one of their patients (not to mention their business partners, contractors, employees, and so on).
Protecting your patients’ personal data is just as important as protecting their health, but new findings suggest practices are better at the latter than the former. The most recent Benchmark Study on Privacy & Security of Healthcare Data by the Ponemon Institute found that the healthcare industry remains "negligent in the handling of patient information."
With that negligence comes an undue level of risk for cybercrime, as well as for all of the legal and regulatory consequences that can potentially come with it. Regularly revisiting your cybercrime protections can help maintain your practice’s financial well-being by keeping fines, fees, and penalties off your radar. Here are five quick tips on maintaining strong protections.
Medical Debt Reality Check: Unpacking New Findings on Patient Responsibility
Inside almost any medical practice, patient collections are an ever-present concern. Since the priority of collecting every dollar from non-paying patients can consume the day-to-day efforts of practice managers and their medical billing teams (or medical billing firms), the issue often gets outsourced to medical collections agencies.
Once a collections firm is involved, the in-house team typically stops worrying about the problem altogether and shift their attention to other things, hoping the funds will simply come in from debtor patients eventually.
But are medical practices overestimating how much they’re really owed?
Medicare Fraud: Doctor Convicted for Multi-Million Dollar Scheme
Instances of fraud in the U.S. healthcare system are anything but rare. Across the entire medical billing landscape, estimates put amount of health care expenditures lost to fraud between 3 and 10 percent.
Medicare is often perceived as a ripe target for fraud, but its rates of financial crime fall somewhere in the same range spotlighted above. While the rate is high, also an area where enforcement efforts are both active and effective: The Medicare Fraud Strike Force has a 95 percent conviction rate with jail terms averaging four years.
News of fraudulent Medicare activity only breaks when charges are filed are convictions are handed down, making it difficult to assess how much it happens among providers generally. When the big takedowns occur, in instances involving high dollar amounts, there’s usually a vast amount of collusion involved; court outcomes typically show that the fraud was a group effort carried out by a number of physicians in tandem.