For all along now, revenue cycle management services have focused only on managing client revenues. Experts now think it could be the right time for RCM services to focus on patient experience and bring down their financial anxiety.
A Kaiser Family Foundation survey recently reported that 45% of Americans worry about unexpected medical bills and their inability to handle them. A 2021 survey states that 92% of Americans are covered by health insurance.
However, even for this population covered by insurance, the coverage is not usually 100%. These policies come with complex copay terms, limits, and eligibility restraints. As a result, some parts of their treatment may not be reimbursed by the primary payers. Diseases, however, don’t appear after checking insurance terms and conditions.
Also, some of the low-premium plans may have high co-pays. Most patients admit not understanding this financial commitment and choosing a plan because the premium value was low.
Healthcare has grown by leaps and bounds now, and thanks to expert professionals, people are living healthier and longer than before. However, according to some experts in the industry, we have been focusing too much on the physical health of patients and ignoring their mental health state.
The end goal of revenue cycle management services is generating, maintaining, and improving the practice’s revenues. One major challenge in this process is getting the total charge reimbursed. Patients may not be able to fulfill their copay commitment for several reasons. Whatever these reasons are, the end effect is low revenue generation for the practice.
That’s why revenue cycle management service providers have to now start focusing on the patients too, and not just on insurance companies.
What happens when patients get financial anxiety?
Let’s assume the scenario of a patient getting admitted to the Emergency Room and needing an angioplasty right then to treat a block in the heart’s artery. After the surgery, the patient is handed over a bill of $12,000 stating that their insurance plan didn’t cover the whole process.
It is easy to imagine the mental trauma the patient and the rest of the family members would go through then. For some patients, making such huge payments may be impossible.
The following things can happen when a patient gets anxious about medical bills.
• The patient avoids visiting hospitals and tries to self-treat, causing more harm.
• The patient undergoes extreme mental stress, which, in turn, affects their health.
• The patient delays or avoids making payments.
• The patient gets aggressive and spreads negative reviews about the practice outside.
• The patient has a bad customer experience and doesn’t return to the practice.
None of these scenarios look great, don’t they? How would you feel if we told you that effective revenue cycle management services could help prevent all these?
Revenue cycle management services and its impact on patient financial anxiety
1.Quick and effective eligibility verification and prior authorization
Eligibility verification and prior authorization are two processes that are essential requirements when it comes to effective revenue cycle management services. Knowing whether a patient is eligible to get the services covered in their insurance and obtaining prior authorization wherever needed can help maximize the amount reimbursed by the insurance company.
Many revenue cycle management service providers miss out on getting these two right, and their patients struggle at the end of the day.
Price transparency is already a law in the United States, and some practices and hospitals are trying to implement it. When your RCM operations are not well-defined, it may get nearly impossible to tell your patients how much the services will cost.
So, the first thing to do if you also want to implement the price transparency policy in your practice is to finetune revenue cycle management services. An experienced third-party service provider like Quintessence may be your best bet to get this sorted in the long term.
3.Prior patient discussions
It is extremely important to have a ground team who will discuss their financial commitments with the patient or their family members when they decide to get treated there. Doing this in advance can help bring down the sudden shock of getting handed over a huge bill.
4.Fair capturing of charges
Most practices in the country try hard to be fair and precisely capture charges for their patients. However, specific unforeseen errors in the RCM cycle can lead to overbilling, increasing the financial anxiety of the patient.
Such overbilling may also lead to the patient losing trust in their service provider, affecting the patient-provider relationship.
Train your billers and coders to capture charges right, ask questions and clarify when in doubt, and audit their processes regularly to prevent unintentional errors.
It is critical for practices to offer financial counseling to their patients when in need. Such counseling may help educate the patients about their different financial options, avenues for additional support, and any alternate options.
While this may seem like a frontend task and not the responsibility of revenue cycle management service experts, do remember that the end goal of the RCM expert is to get charges reimbursed right, and patients are also payers in most scenarios.
So, apart from maintaining good relationships with insurance companies and getting in touch with them regularly, RCM experts must also build this relationship with patients.
6.Flexible payment options
Integrate flexible reimbursement plans within your revenue cycle management service operations. It is not uncommon for practices to even offer EMI payment modes to their patients, especially when their bills are enormous.
Patient financial anxiety is becoming a common problem globally, and healthcare practices must take the right measures to bring this factor down if they want their treatments to work. Tweaking existing revenue cycle management services and bringing in RCM efficiency and precision may not seem straightforward to handle patient financial anxiety at first glance.
However, if you think about it, this would make perfect sense.
If you have also noticed an increase in patient anxiety regarding bill payments or are struggling to collect copays, then definitely get in touch with our revenue cycle management service experts at QBSS.
We understand the industry like no other and will be able to bring in RCM differences that help your patients get rid of their anxiety and get more confident with visiting you.
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