PracticalDermatology

Mailing medical bills 30 days after an encounter is a sure-fire way to lose money in the new world of high deductible health plans and changing payer models. In fact, the most efficient way to collect from patients is while they are still in the office, and, in some cases, before they arrive. High performing practices ask their patients how—not if—they would like to pay their bill today. Creating pricing transparency is the new imperative for providers, since data show that the probability of collecting from a patient after he/she leaves the office drops to less than 20 percent.¹ Today’s tech-savvy practices are leveraging fully integrated systems to ensure they provide a satisfying patient payment experience and fully optimizing their processes to drive profitability. In fact, it’s becoming nearly impossible to create the kind of pricing transparency that healthcare consumers demand without a fully integrated practice management and Electronic Medical Record (EMR) system.

Benefits and features of a fully integrated platform

Dermatology is a specialty that fully embraces technology. Most dermatologists were early adopters of EMRs and patient portals and value integrated technology solutions that enable speed, efficiency and positive patient experiences. Today’s high-speed providers need to move quickly across encounters by optimizing billing transparency and efficient scheduling. In an increasingly consumerized healthcare environment, patients must be informed of their full financial responsibility in the front office at the time of check-in.

Top performing practices are taking full advantage of integrated solutions and engage with patients through their patient portals by employing features such as e-eligibility, e-billing, and e-remittance. E-eligibility tools allow staff to verify patient eligibility, co-pays, and benefits in advance of scheduling and rendering services. For example, administrators capture insurance information from patient portals prior to visits to increase efficiency in billing and scheduling. Building these processes into current workflows helps patients understand their financial responsibility earlier in the delivery of care.

Many top performing dermatology practices are also leveraging systems that offer a holistic integration of revenue cycle, clinical documentation and even inventory management in a single platform. On the revenue management side, electronic eligibility, billing and remittance information flows seamlessly across the practice, even providing instant alerts to a physician when insurance does not cover a specific procedure or treatment.

The integrated systems approach ensures both data integrity and data liquidity, providing the ability to maintain a single patient record with complete financial and clinical information. The moment a physician enters clinical data into the EMR, activities such as payer remittance and accurate patient billing occur simultaneously. Further enhancing the patient experience, inventory management allows a patient to purchase over the counter products during a visit and receive a single, itemized bill.

Meeting consumer demand with pricing transparency

In contrast to the efficient, high-speed practice with an integrated system, consider the potential problems of trying to work with two or more disparate systems. Usually this means the practice has two systems, a PM and an EMR from different vendors. The practice management system may have e-eligibility built-in; however, when the patient is seeing the physician and the encounter is documented into a disparate EMR, the data must now travel across an interface to the practice management system to generate a bill. In this case, the PM system can provide some billing information, but until the physician enters the tests or treatments, the patient has no way of knowing exactly what they will owe beforehand.

With two different systems, the front office may attempt to collect a higher balance or back office staff must follow up by mailing bills after services are rendered, making collection far more difficult and potentially risking revenue loss. In a changing business environment where pricing transparency is critical to efficiency and profitability, it’s easy to see why more dermatology practices are moving away from multiple systems and embracing integrated solutions.

Maintaining a profitable practice

Practice leadership should look at the totality of their systems, focusing not only on speed, but also on productivity and profitability, making sure they are not sacrificing one for the other. Exploring every opportunity to enhance the patient payment experience is critical in reviewing systems and processes. Every aspect of patient billing and payment affects the profitability of the practice. For example, providers need be aware of the new Europay, MasterCard, Visa (EMV) changes and review their credit card readers or terminals. Those systems must be ready for the new credit card chip and pin technology or providers can potentially face liability for fraudulent charges.

Practices struggling with multiple systems are at a distinct disadvantage in today’s market. For providers that are not collecting patient payments at the time of service, the chances of the check being in the mail are fading fast. n

Eric Nilsson is Chief Technology Officer for Nextech.

1. http://news.aapc.com/two-thirds-of-physicians-responsible-for-own-pay-cut/