All medical practices have a certain amount of their revenue blocked as Accounts Receivable. This is normal, and it is the job of the backend team to bring down AR numbers and stabilize payments received. A very considerable and challenging part of AR is patient balance.
is the balance cost that a patient is required to pay after the insurance payer settles the bill. Let's assume a patient was admitted to a hospital, and the final bill was $1000. The payer sees an out-of-network service provided for a charge of $200 in the claim and refuses to pay for the same. The claim is settled for $800.
As a result, the patient is required to pay the remaining $200. This is just one example. All out-of-coverage services have to be paid for by the patient. Also, factors like co-pays and co-insurance may require a person to make a patient balance payment to the healthcare provider out of pocket, apart from the insurance settlement.
It becomes the duty of the billing and transmission team to keep track of these patient balance values and consolidate them and generate statements. Many practices that don't follow up on these patient balances have hundreds of thousands of dollars unreceived for services provided months ago.
This is the practice's hard-earned money that should have been paid for. While getting a patient to pay out-of-pocket by itself is a challenging task, missing out on them or sending out bills very late (after discharge) can all bring down the chances of actually getting paid.
Handling patient balances
The best way to handle patient balances is to stay on top of it. Billing teams tend to ignore these and often choose to write them off because, individually, the numbers could be small, and the team could be fully engaged in handling bigger claims.
However, when compiled together, patient balances could become a considerably big figure that is otherwise lost in revenue for the healthcare practice.
Here are a few tips from experts to help handle balance collection.
- Figure out patient balancesin advance and discuss with the patient the possibility of them having to pay out-of-pocket. This will keep them prepared.
- Try working on upfront collections wherever possible. The billing team needs to be extremely proactive and quick for this to work.
- Get your billing team to offer flexible payment modes to patients to help them pay. Some hospitals even offer installment payment plans.
- Have a team that can reach out to patients who haven't settled their bills yet and try and figure out the reasons and solutions.
- Make sure your billing team is large enough and well-rested so they can focus on patient balance.
Conclusion
Start by looking at your payment postings and find the total money stagnant in accounts receivable because of patient balance. This way, you will know how much you are due and how much you lose every year. Train your billing team to spot and handle these balances quickly and efficiently.
Read more:
Coding, Audits, and Compliance – The core of RCM services
Understanding Eligibility and Benefits Verification And Their Importance
Succeeding At Healthcare Revenue Cycle Management Services
