Practice Management Alert

One payer offers you a new tool that may help you collect from patients. Rising costs and increased patient payment responsibility is hitting some practices where it hurts -- their income. But some payers, such as Highmark in Pennsylvania, are offering you a tool to help you bring in every dollar. In today's struggling economy, letting patients know their healthcare costs before your physician provides service can help ensure that you actually collect all the money you-re owed. Look Forward to Lower A/R Highmark has introduced a real-time tool that will allow billing and collections departments to estimate the cost of services for specific patients. In turn, the hope is that patients will gain a better understanding of their individual payment responsibility and that the tool will allow the practice to set up financial arrangements when necessary. The cost estimation will take into account the individual patient's health plan, including deductibles and coinsurance. "I think access to a tool like this can greatly benefit a practice and help increase and retain revenue, as well as decrease denials," says Nicole Martin, CPC, compliance auditor for Abington Memorial Hospital in Pennsylvania. "I would expect with proper education and expectations of staff and patients, this tool will be highly successful in decreasing overall A/R and denials." New Tool Can Increase Patient Cost Awareness The new Highmark system has two components: real-time provider estimation and real-time claims processing. "Real-Time Provider Estimation allows the provider to submit requests for specific health care services -- before a member receives care or at the time of service ��" and estimate the member's financial responsibility within seconds," Highmark explains. "Real-Time Claims Processing gives providers the added ability to submit claims for specific health care services and receive a fully processed claim response within seconds." You-ll be able to use these cost-estimate tools prior to service or at the time of service, and then you can either immediately collect payment or make payment arrangements with the patient. The benefit: "This will allow providers to let the patients know exactly what the insurance will or will not pay so that they can determine whether or not they want to go ahead with the procedure," explains Dianna MacDonald, practice manager for George L. Rosenberg, MD, PC, in Natrona Heights, Pa. Bonus: "If we can collect what is due on the day the procedure is performed, it will make my life much easier because I won't have to bill the patient and wait for the payment to come in," MacDonald says. "If the patient cannot pay in full, it would allow us to set up payment arrangements immediately." Revamp your process: If your practice has access to a real-time claim estimation or claims [...]