Best Practices in PO$ Collections. Reach for more.... Presenter: Jonathan Hendricks Revenue Cycle Consultant Recondo Technology. Overview. Industry Statistics Compliance Issues CASH principle Opportunity Areas Scripting Reach for more. Industry Statistics.
Revenue Cycle Consultant
*Bureau of Economic Analysis - Personal Consumption Expenditures by Major Type of Product and Expenditure
What are the benefits?
How do these work?
What major impact/process flow does this have for healthcare providers?
Significantly improve the bottom line of your organization through:
Providing patient financial responsibility to patients is new to many people regarding healthcare services.
EVERYONE has to be educated on the “why it is important”.
Education starts with your own hospital staff
Others to be educated:
Who are some of the worst offenders of not paying their financial responsibility to you yet is closest to the organization?
You got it……..your own employees!!!
The next step is to determine the best and most effective ways to communicate your plans to patients.
If patients are informed they will respond!
Nice to have:
Systems with “rules based” architecture
Historical claims data (pros/cons)
CDM and Contract mgmt info
Automation, Automation, Automation
270 – Eligibility request
271 – Eligibility response (many are lacking)
278 – Precert/Authorization notification
Hospital Inpatient 48 MRI/CT 62
Hospital Outpatient 50 Maternity 69
Amb Surgery 53 Phys Office visit 98
Emergency Accident 51 Phys Office IP 99
Emergency Medical 52 Phys Office OP A0
General Benefits 60 Nursing Home A1
Emergency Services 86 Skilled Nursing A2
Diagnostic X-ray 4 Well Baby 68
………..and on…..and on……and on………
Host system vs Vendor system retainer
Integration vs non-integration
Price transparency options
On-line pre-registration options
Automated authorizations status
Automated claims status
Call center (HUB environment with phone queue)
Automated work lists and go paperless when possible
Automated call reminders for appointments and pre-register
Automated cash tracking tools
Secure pay-by-phone tools
Does the staff have the right knowledge base around –
Why is pre-registration so important?
Although scheduling should be obtaining limited insurance information, pre-registration gives you another chance to obtain complete insurance details.
On-line pre-registration is encouraged so upcoming visits are allowed lead-time for verification and pricing.
Web page reminder – This also gives another avenue to remind patients that there may be financial expectations for their visit.