The truth is that the job of patient accounting is to bring in the cash. Cash is always important in every business, but when it pertains to healthcare it’s even more crucial. In today’s America, more than 80% of all hospitals are losing money each year, and reimbursements from insurance companies are being reduced. All medical entities, even physician’s offices, are having to try to find ways to deal with the loss of some of these reimbursements, as well as tighten up as it pertains to expenses.

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Here are four ways to possibly help give a quick boost in cash, as well as tighten up on some of the losses as it pertains to expenses. You may not be able to do all of these, and some of them you might have to get permission from upper management to implement. But I will guarantee that you will show an increase in cash of at least 5%, if not 10% or more, and a decrease in expenses of the same, within 60 days.

1. Change all accounts with insurances you don’t participate with over 30 days, and under $5,000, to self pay.

There are no rules that say you have to keep claims in a commercial insurance financial class until they’re paid. Truthfully, there are no rules that say you even have to bill claims for insurances you don’t participate with.

The psychology of doing this is that patients believe we went out claims, and they get paid, and that’s all there is. The truth, as we know it, is that many insurance companies not only don’t pay us within 30 days, but often pay the guarantors without any notification to us.

By changing these claims to self pay, a few things happen.

One, if the patient received the payment, they’ll know they have to turn it over to the hospital.

Two, if the patient didn’t receive a payment, they know the hospital hasn’t been paid, and insurance companies listen to patients more than they listen to billing entities.

Three, it relieves your billing department of having to follow up on the majority of these types of claims, leaving them more time to work on everything else, especially those high dollar insurance claims that you’re retaining.

2. Offer a one time 25% discount on all self pay claims of a certain age.

There are no rules that say you’re not allowed to offer discounts on self pay claims. The only requirement is that it has to be offered to all patients who fit the same criteria.

For instance, Medicare patients who owe a self pay balance have to be offered the same discount as everyone else; that’s not hard to do. You don’t have to worry about offering the same discount to insurance companies because, if you participate, you are already discounting the cost of your services to them, and if the patients don’t have any out of pocket cost then there’s nothing for those patients to worry about.

The point to a one time discount is that people love getting discounts of any kind. In New York, every year there’s a period of time where certain items can be purchased tax free. That amount ranges from only 3 to 8% for most communities, yet it always ends up being a major boost to local economies.

If your entity decided to offer a 14 day opportunity to pay their self pay bill with a 25% discount on an account that was over 60 days in self pay with no activity, at least half the people who receive the offer will pay the entire balance. A good portion of the rest will probably call you to ask if they can set up some kind of payment arrangement and still get that same discount. Whether you grant a discount on a payment arrangement is up to you, but you’ve still accomplished something, that being the patient reaching out to you rather than you trying to track them down.

3. For one week, sort your receivables by highest dollar and work those claims only, going as low as you can.

By this, I mean “work” the claims. Research whatever needs to be researched, make the phone call, don’t take any answer besides “we’ll be processing that claims on ______.

What may happen is that you’ll be asked for some extra information; tell them you’ll fax it, and that you’ll be calling them ten minutes after you fax them the information. Don’t let them dictate the terms for getting information to them; don’t let them ask you to put something in the mail.

There’s two good things about doing this. One, people tend to like to work higher dollar claims, so they’ll give these claims more effort than lower dollar claims. Two, they represent bigger reimbursements, and if you get them worked properly you should see the fruits of your labor within 2 weeks. Truthfully, you could do this once a month, but at least initially it’ll give you a great boost in cash.

4. Immediately stop wasting paper.

Even today, people tend to want to print information off the computer to look at rather than just reviewing everything while it’s on their computer. I know this can be comfortable, but it’s a major waste.

Some people print out every single email they receive to put them in their files. Email doesn’t take up that much space, so why not create a folder on your computer to save those emails instead? You can move them out of your inbox into a folder on your computer, or onto a floppy disk as a text tile, and that allows you to take your files with you or move them totally off your computer if you’re afraid someone else will still be able to access your files.

To put this one in perspective, it costs about $21 for a box of white paper. Each box contains 10 reams of paper, each ream, or pack of paper, about 5,000 sheets. Most normal offices go through at least 2 boxes of paper a month. They that means there’s about 10,000 sheets of paper they’re printing.

If you have a laser printer, it probably has a cartridge that will print about 3,000 sheets of paper per cartridge that runs about $75 each. That means you’re probably replacing that cartridge at least 3 times a month.

Out of all that paper, studies have shown that you’re probably throwing away or shredding at least 75% of it. That means more garbage bags, more cost of labor in someone carting it away (especially if it’s shredded, confidential information), more time wasted in getting up from the desk, going to the printer, coming back, wadding paper up, throwing it away,… get the picture?

By extension, apply this to itemized statements. Many facilities print off itemized statements as well as balance bill statements. There are no rules that say you need to send itemized statements to patients who don’t request them, and it’s to your benefit not to do it, except for patients who are self pay from the beginning.

You don’t have to send them an itemized statement unless it’s requested, but it’s ethical to send them something. If your entity automatically prints these statements, turn it off. Or, if you prefer sending itemized statements instead of balance bill statements the first time, then don’t print the balance bill statements.

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