Doctor smiling - three myths whitepaper

New Whitepaper Debunks Three Myths about Upfront Patient Financial Counseling and Collections

To combat climbing health insurance deductibles and co-pays that push a larger portion of the cost of surgery from insurers to patients increasing collections risk, ambulatory surgery centers (ASCs) have responded with more robust financial pre-registration processes to maintain efficiency and profitability. A new whitepaper offers insights into this trend, while separating myth from reality regarding implementation.

Regent RCM’s Erin Petrie, Director of Revenue Cycle Management, says while there was resistance in the marketplace to upfront patient financial counseling and collections just a few years ago, the practice is rapidly gaining acceptance today. More than 90% of patients want to know their payment responsibility prior to a provider visit or scheduled procedure.

“In response to the trend, we’re making sure to include in our financial planning process an upfront review of the patient’s benefits,” she says. “Taking this step helps ensure transparency about out-of-pocket expense, so costs can be estimated, explained, and ideally, collected in advance of services being rendered. It makes patients more comfortable about their financial commitment and reduces our risk on the backend.”

Regent RCM, a leading provider of innovative and cost-effective revenue cycle management services exclusively for ASCs, is working with leading ASCs to put programs in place that operationalize upfront patient financial counseling and collections, and to dispel outdated myths that keep centers from benefiting from these proactive processes. The new whitepaper, available for free download here, addresses three common myths:

  • Myth #1: Advance collections won’t work.
    Reality: It’s happening. And it’s helping.

  • Myth #2: The practice lacks physician support.
    Reality:
    Physicians understand that healthcare providers must embrace good business practices in order to stay solvent and continue to provide quality care.

  • Myth #3: Attempting advance collections might prompt surgery cancellations.
    Reality: Patients appreciate transparency around what charges they’ll be accountable for and understand that high deductibles are the new norm.

The white paper offers proof that payment only after services are delivered is an outdated mindset in healthcare, citing the advance collections experiences of two leading ASCs, Glasgow Medical Center in Newark, Delaware, and Palos Surgicenter in Palos Heights, Illinois. The paper also offers four suggestions for ASC leaders interested in implementing advance collections.

To learn more about Regent RCM’s work with ASCs to implement upfront patient financial counseling and collections, contact Favela at lfavela@regentrcm.com.

Regent RCM Guide Identifies Inefficiencies and Mistakes that Put ASC Financial Performance at Risk

What can surgery center leaders do to ensure an efficient revenue cycle? What processes can be enacted to minimize mistakes in coding, billing and collections? Regent Revenue Cycle Management, a leading provider of innovative, cost-effective revenue cycle management services exclusively for ambulatory surgery centers nationwide, has published 3 Revenue Cycle Audits That will Improve Collections and Lower Days in A/R, a new guide that offers strategies to enhance efficiency and drive growth in 2019.

“No one wants to miss out on revenue due to insufficient revenue cycle management practices,” states Erin Petrie, Regent RCM’s Director of Revenue Cycle Management. “Our new guide illustrates through best practices and case histories that follow simple—yet critical—processes can ensure that when mistakes are made, they are corrected quickly, and new processes can be enacted to make sure you rarely make the same mistake twice.”

This publication outlines the recommended timing and processes for analyzing and improving:

  • Denied claim cause and management
  • Coding accuracy
  • Payer contract adhesion

3 Revenue Cycle Audits that will Improve Collections and Lower Days in A/R will help centers to collect every dollar they are owed and set them up for long-term growth and success,” Petrie states.

The new guide is available for download now.

ASC Collections

Diligent Appeals Process Accelerates ASC Collections and Minimizes Premature Write-offs

Revenue Cycle Supervisor Vianca Bautista has helped shape Regent RCM’s diligent appeals process designed to accelerate ASC collections and avoid premature write-offs. She supervises four revenue cycle specialists, while managing her own ASC client, so it’s no surprise that Bautista is highly skilled at getting claims paid. In the following post, Bautista shares her insights about successful insurance appeals, details about the Regent RCM appeals process and how diligence pays dividends for ASC clients.

“When a claim isn’t receiving reimbursement according to the contract or if it is underpaid, this triggers our diligent appeals process so we can get to the root of the problem and then pursue the expected payment immediately,” said Bautista. “Our process begins with a phone call to the payer and that takes place the very same day or the day following receipt of an underpayment.”

If the claim can be reprocessed with additional information, it’s sent back and Regent RCM’s revenue cycle specialist will then follow up 30 days later.

“These automated triggers, along with immediate follow-up fix most, but not all problems,” Bautista adds.

If the claim cannot be reprocessed, a first appeal is sent out and if the payer still maintains their position, Regent RCM will send a second appeal, and, on rare occasion, a third.

While no one can achieve a 100% clean claim rate, proper coding and using a robust clearinghouse to scrub claims prior to submission bolster success. The Regent RCM gold standard is less than 5% denials and a 98% clean claim rate.

“If there is a secret to our success, it is consistency. Our automation catches issues and we have steps in place that will get revenue cycle back on track,” stated Bautista. “We are determined to recover every dollar for our clients and write offs are a last resort.”

Are you interested in learning how Regent RCM revenue cycle specialists can leverage appeals to accelerate ASC collections and avoid premature write-offs? Call 312-882-7228.