We all welcome a new year, but with it comes changes to many patient’s medical coverage that can potentially increase patient responsibility. For example; Medicare patients have an increased Part B deductible of $183 effective January 1st (1) while plans obtained through the Health Insurance Marketplace may have changed as recently as December 19th and could continue to change through January 31st (2). This time period can be frustrating for patients that have switched insurance carriers or policies leading to confusion of their coverage benefits as their deductibles, copay, and coinsurance may have increased. Follow the steps below to avoid having a slow start to the year.
Step One: Insurance Must be Verified at Every Visit
Your front office staff must brush off the holiday blues and be diligent with every patient interaction. Staff should double check each patient’s coverage(s) eligibility and benefits at each visit in order to maintain an efficient revenue stream for the practice. Secondary coverage should also be verified to determine patient or carrier responsibility for primary carriers cost share. Under collection of deductibles, copay, & coinsurance due to failure to verify patient eligibility and benefits may lead to a significant loss in office collections and a higher A/R. Some patients may even experience gaps in coverage due to changes between carriers resulting in them owing a copay one visit and a self-pay balance the next.
Step Two: Set Goals for the 2017 Year
The beginning of the year is the best time to establish revenue goals. Start by using January 2016 as a benchmark and see if collections, specifically in the office, are improving for January 2017. Your staff will work better if encouraged, praised, and/or incentivized. For training tips and best practices , contact Medical A/R Revenue Solutions, LLC at 850-219-0111 or email jamesb@armedicalclaims.com today to schedule your free consultation!
Author: J.R. Blue, MPA, CPC, CPB, CPPM
- Medicare.gov (Dec. 27, 2016). Part B costs. Retrieved from https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html
- HealthCare.gov (Dec. 28, 2016). A quick guide to Health Insurance Marketplace: Dates & deadlines for 2017 health insurance. Retrieved from https://www.healthcare.gov/quick-guide/dates-and-deadlines/