Improve Your Practice's Billing Process in 2015: 3 Tips

When I get a rare chance to play poker with some of my friends ($0.50 is a big pot in our game) there is one thing I know: No matter how much I wish and hope, after the deal, my cards just don’t change. But the thing I love about poker is that even with bad cards, you can still win if you play them right.

In the midterm election, the people of our country spoke pretty loudly about changing the status quo with government. There has even been talk about trying to use this new leverage to repeal the Affordable Care Act (ACA).

However as time goes on and more Americans rely on the health insurance marketplace and exchanges for their health insurance, it will be harder and harder to take the ACA away.

It is the hand that we have been dealt and so now we have to learn how to play it.

Because of the ACA and other pressures on employers to control healthcare costs, the deductibles that people will be paying this year will continue to rise to record levels.

According to HHS data released in May 2014, almost two-thirds of people on the health insurance marketplace selected the Silver Plan, which has a family deductible around $6,000; and another 20 percent of people selected the Bronze Plan, which has a family deductible around $10,000. So over 80 percent of families on the new exchanges have a deductible of at least $6,000. 

Because of this, in 2015 practices can expect to collect a majority of their revenue directly from their patients through the first six months of the year as opposed to from insurance companies. Practices must make sure they are ready for this and can take three important steps now to prepare.

1. Ensure that your billing is being done properly. According to Medical Billing and Coders up to 30 percent of income at a medical practice is lost due to improper billing. Make sure that claims are submitted quickly too, as payments take time to process.

2. Ensure your practice technology is up to date. From your scheduling software to your billing applications, there are a lot of features that are available to you through your practice management vendor that you should be taking advantage of. They have done a lot of the work to make sure they are providing value to you, make sure you leverage their work.

3. Make sure your back office is in order. The financial success of a practice can come down to successful execution of your back office. However with the increase in workload due to the healthcare reforms, your back office is left with less or almost no time to handle the important issues to keep a focus on your bottom line. Make sure your staff takes the time to ensure that all processes are being properly monitored and give it time to find new and innovative ways of doing business.

Remember, you can’t change the cards you’ve been dealt but you can change the way you play them.

Tom Furr is the chief executive officer at PatientPay, Inc, a patented, cloud-based service for physician groups and their patients to process and manage bills and balances. E-mail him here.