Breaking Bad - How a Show Can Alter Your A/R Methods

In the hit show, Breaking Bad, Walter White is faced with a terminal illness that would eventually leave his family in financial ruin after he passed away. Thus faced with a decision, the chemistry teacher, turns to manufacturing premium methamphetamine to augment his family's finances. This show can teach the medical industry, and especially private practice, a thing or two about changing Accounts Receivable strategies.

Healthcare has been plagued with being a costly necessity to individuals and families, and it would behoove us to offer options for this necessity. Here are some A/R methods that can help take the pressure off of your patient's when it comes to affording your rates.

1. Develop clear lines of communication regarding payment responsibilities A well-known voice in the United States has aired a concern about healthcare that reverberate with many people. This concern is the lack of transparency when it comes to pricing healthcare services. It is like going to the store needing to purchase an item, but the store makes you agree to that item before showing you how much it costs.

In private practice, this doesn't always need to be the case. Some practices can be very open and even flexible with their pricing. By outlining what each session will cost and when payment is due, you help manage the client's expectations when agreeing to seek help, and for collecting money down the road.

2. Improve coding, documentation, and intake procedures to minimize the amount of denied claims

One reason why it is important to have accurate coding, documentation, and intake procedures is to limit the amount of denied claims and to give the client the best idea of what they owe. When you or your biller take the time to check eligibility before services are rendered you have the clearest picture of what the insurance status of your client is.

By getting their information right on the claim the first time, you ensure your client doesn't incorrectly get an invoice in the mail by your biller or insurance company. You also avoid having to send out that patient statement at a later date, which can then catch the client off guard. This avoids tension and stress on the part of the biller, therapist, and patient.

For example, we know of a biller who would wait until the end of the year to send out patient statements (NOT best practices). This would leave patients with unexpected $700 bills. When you haven't received a bill for the entire year, you probably aren't expecting one to show up in your mail. Especially not one of that size!

3. Consider implementing an EHR that helps funnels claims through your practice

One reason why Electronic Health Records have become so popular is the rate of duplicated claims becomes almost extinct. As you can see a clear path from session to billing this helps to streamline the billing process efficiently and effectively. This typically means your claims will be paid quicker, allowing for money to not be warehoused on the books for months at a time.

So if you do terminate treatment, you can terminate and not have to constantly go back to your client asking for money or updating them on the financial status of their claims.

4. Develop payment plans for lower income households

Finally, develop policies that allow for flexible payment plans for those who need services but who might not be able to afford them right away. A good rule of thumb when working for insurance companies is to ask them what their policies are on giving discounts to patients with insurance. There are legal guidelines for providing discounts when contracted with insurance companies.

According to specific laws that govern healthcare, whatever benefit you give to your patient, the same discount must be proportional to the insurance company. For example, if you bill X Insurance company 80 dollars with the client assuming a 20 dollar copay (20% coinsurance), but you want to cut your patient a break and charge them 10 dollars (10% discount). You must bill the insurance for 72 dollars and charge the client 18 dollars. It's not as simple as writing off expensive co-pays and deductibles. If there is a family/individual with need, check the regulations and offer what you are able.

When altering or adding new A/R methods it is a good idea to run your ideas past your biller. Often times therapists want to give free therapy to people by writing off co-pays and deductibles, and in some cases this can warrant legal action by the payer. Otherwise, there are actions you can take to make sure your patients don't have to resort to drug dealership to pay the bills!