Across the healthcare spectrum, providers are battling a familiar foe: delay in payments. This growing problem is exacerbated by complex medical billing management processes, leaving many practices needing help with diminishing margins and cash flow issues. Fortunately, there are solutions available to help providers recover from or avoid these administrative hurdles while improving the status of their revenue cycle management (RCM) practices.
This post reveals the top medical billing challenges facing providers today, including:
How lack of patient education and outdated billing methods delay payment.
How workflow issues can cause missed revenue opportunities.
Patients and sticker shock.
Payment and processing delays.
It also offers valuable insights and strategies to address these issues, including the benefits of integrated payment options and how this solution can break through multiple billing obstacles - improving a medical office’s entire RCM.
Lack of Patient Education & Outdated Billing Methods
According to a Patient Engagement HIT survey, less than half of healthcare consumers understand their medical bills. Moreover, about half of those responding to the survey also said they pay their medical bills late, with many citing confusion as a reason. The report also found that consumers voiced their frustrations regarding patient billing and payment processes. Nearly a third believe that healthcare providers can do more to improve these procedures, including using better technology.
Case in point, 49% of survey respondents stated they were frustrated about their provider’s lack of adoption of digital administrative processes (e.g., online bill pay, access to insurance information). Participants also state their providers still notify them about healthcare bills via traditional mail. Only 55% said their provider uses an online patient portal, and even fewer said email and text. According to Fiserv, 62% of all bills are paid electronically, and 93% of consumers reported that they prefer to pay their medical bills online whenever possible.
What are all these statistics telling providers? Without advanced medical billing software and online payment options, their offices may suffer financially - especially those with smaller practices. For example, according to an article in the AMA, balancing clinical obligations with administrative work, such as coding, paperwork, and prior authorization challenges, overwhelms smaller private practices. The article revealed that one physician was forced to sell their practice to a hospital system to cope with the unsustainable administrative workload. Providers should remain safeguarded against these ever-evolving challenges. They need viable options to keep their practices open, thriving, and supported.
Healthcare consumer delays in payment are also attributed to unanticipated out-of-pocket expenses, according to survey results in Revcycleintelligence. Approximately 60% have tried to get out-of-pocket costs from providers ahead of care, but 51% reported that they could have received it more efficiently and accurately. The truth is price transparency is often missing in the healthcare industry, leaving patients susceptible to sticker shock when receiving their medical bills. According to one report, less than half (42%) of healthcare organizations offer a cost estimate for patients before an appointment.
How can medical offices address these challenges? According to the previous surveys, here is a round-up of strategies practitioners can take to ease patient billing - and get paid much faster:
An upfront explanation of what a healthcare payer will and will not pay for
Increase price transparency and flexible payment options
Creation of a more straightforward billing statement with only essential information
Improve customer support for immediate billing inquiries
More online payment options
The Cost of Medical Billing Workflow Issues
According to The Change Healthcare 2020 Denials Index, the average denials rate has been up 23% since 2016, and since the onset of COVID-19, denials have risen 11% nationally. Some of the top reasons for denials include the following:
Missing or invalid claim data
Registration and eligibility issues
Medical coding issues
As seen in this report, when it comes to medical billing and coding, having a smooth workflow is everything. Even the slightest mistake can result in a claim being bounced back by the payer, causing payment delays and missed revenue opportunities.
Poor workflow issues also lead to an unsatisfactory patient experience, causing a sour impression that lingers long after they leave. In fact, 1 out of 3 healthcare consumers is unsatisfied with their healthcare provider’s medical billing process, according to Revcycleintelligence. One survey by Electronic Health Reporter reveals that 36% of patients have left a healthcare provider in the last two years due to issues with costs or billing. If paying for care is challenging, patients tend to put it off or forget.
The good news? The Change Healthcare 2020 Denials Index report also reveals that 86% of denials are potentially avoidable. For instance, investing in an advanced online payment solution can simplify medical billing processes and make them more efficient. Doing so not only streamlines workflows but also reduces the workload - facilitating better outcomes for practices. Staying proactive and on top of claims leads to faster and higher reimbursements, financial security for providers, decreased turnaround time reworking rejected claims and payment clarity for patients.
Payment & Processing Delays Billing and coding procedures are complex, often leaving practices waiting weeks to see payment.
In fact, practices usually wait 60+ days after appointments to see payment for services rendered. Why the lag in revenue? Even as EHR systems become more commonplace for payers and providers to share data, manual work still heavily influences the process. Despite ‘electronic’ being a buzzword in healthcare technology, many errors can arise without automation. According to the Council for Affordable Quality Healthcare (CAQH), automation could save more than an hour of staff time for every three claim status checks. With this in mind, keeping medical billing and coding as streamlined and automated as possible is vital. If not, payment and processing delays may result.
One way to reduce delays is having users process payments through a patient portal without using a third party. Third-party processor fees can add up, especially for large practices. Practitioners may spend over $1,000 monthly on credit card processing fees alone. Including integrated payment options like these allows physicians to optimize and streamline RCM, saving time and money. But the benefits do not end there.
How Integrated Payment Options Transform Practices Providing advanced integrated payment options can be a game-changer for today’s practitioners.
According to a report in Healthcare Finance, 85% of consumers own smartphones, yet 90% of practitioners still send out paper bills. With solutions like DrChrono Payments, providers interact with patients by engaging them where they are - online and on their mobile devices. Directly embedded in the DrChrono workflow, DrChrono Payments provides a fast and simple way to request and collect payments from any location or device.
For real transformation to occur in today’s practices, they need to interact with patients in methods they prefer. DrChrono provides this capability by offering solutions, including:
Streamlining Payment Workflow
Automated patient statements and payment acceptance through DrChrono Payments will simplify and streamline payment workflow.
Save time with DrChrono Payments by quickly creating digital invoices to send and receive online payments in one seamless transaction.
Accepting Payments Anytime, Anywhere
Accept payments at any time from any location with DrChrono Payments.
As stated earlier, practices often wait 60+ days after appointments to see payment for services rendered. With DrChrono Payments, over 96% of patient claims are paid within 60 days.
A Bright Future Ahead
With so many medical billing changes and regulations out there, it can be hard to keep up. This post revealed the top ones facing providers today and how these hurdles often delay payment, putting a financial strain on healthcare practices. Fortunately, it also delivered targeted strategies available to help practitioners recover from or avoid these administrative hurdles.
By including integrated payment options like DrChrono Payments as part of these strategies, physicians can optimize and streamline RCM, saving valuable time and money. Allowing them to get back to what matters most - quality patient care.
Want to learn more about how integrated payment solutions can transform your practice? Schedule time with our dedicated support team for more information.