Healthcare billing practices are grossly out of date; ironically just as out of date as our current payment system. Current systems were established post WW2 when employer sponsored plans paid for almost 100% of the price of care.
Today, 50% of plans are HDHPs carrying $2000-$4000 annual deductibles with $4000-$10,000 annual out of pocket maximums. This new reality needs a new system for collecting for services provided.
This new system will require an all out culture change, in and out of our organizations. We need to educate staff, physicians, patients, payers, plan sponsors, etc. This new system requires that providers collect AT THE TIME OF SERVICE.
Yes, I can already hear your objections, because I’ve heard them all over the past 5 years as I have attempted to implement this new system in organizations with staff who have been in their jobs for many years. They remember the “good ol’ days” when all they needed to do is greet the patient and ask them to take a seat.
Today, the new system requires that our receptionists/front desk staff/ or what ever you choose to call the staff responsible for first contact, to do many more tasks. I have advocated for some time that we should be moving billers from the business office to the front desk.
Using the 80/20 rule, most practices should easily be able to produce a visit price estimate prior or during a visit, for their most common visit types. Then we need to add a check out process. If you need to be trained, contact your local dentist, they figured this out long ago since dental coverage most often covers only 50% at best. This is now our new reality, we can learn good collection practices from our dental colleagues.
Action items:
- Retrain front desk staff
- Move billers to the front desk
- Develop price estimate tools
- Educate patients/staff/providers
- Redesign patient flow, incorporate check out process
The time to act is now. You can’t afford to have your A/R increase another 10% in 2012.
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