SECURING PAYMENTS: SELF-PAY PATIENTS AND EMERGENCY SERVICES

Emergency services and self-pay patients- something that emergency service providers do not like to hear used in conjunction with one another. But unfortunately, due to the Emergency Medical Treatment and Labor Act enacted in 1986 and the ever rising cost of medical care and unemployment rates in the US, this is a trend that continues to rise. Do not let this rising trend give you anxiety when it comes to reimbursement.

Medorizon knows that self-pay accounts are very time consuming accounts even for the most efficient employee to work. With that being said, we have a few strategies to share when it comes to maximizing reimbursement for self-pay patients:

  1. Verify patient demographics- even when the patient is self-pay it is crucial that the correct patient demographics are obtained; this will cut down on expenses with returned mail. It will also help expedite payments from patients who do want to pay if they receive their bill in a timely fashion.
  2. Unfortunately, because our patient’s lives are so busy, medical insurance coverage is usually one of the last things our patients are focused on and on rare occasions forget they do have medical insurance. Therefore, if thorough research is being done on the patient’s demographics you might also find the patient is covered by some type of medical insurance policy that can be billed for the services provided. If this information is obtained promptly by the billing staff this allows the correct insurance to be billed in a timely fashion which in turn will mean quicker reimbursement. If thorough research is not done on the patient demographics, the provider is now at the patient’s mercy waiting either on insurance information or payment on the account.
  3. Lastly, when reviewing the self-pay accounts make it a point to reach out to the patients who want to keep their accounts in good standing and show interest in making payments first. In doing this the billing department is usually able to obtain payment in full or establish a payment arrangement so there is some type of revenue being applied to self-pay accounts.

Due to the nature of the beast, emergencies are sometimes not only hard to treat physically but even harder to be compensated for. At Medorizon we know working a self-pay ledger is a tedious process with little reimbursement when all is said and done. Remember, keeping the strategies above in mind when dealing with a provider’s self-pay ledger not only benefits the provider’s reimbursement rates, but it also helps cut cost by applying valuable time to work the accounts with more potential when it comes to bringing in payments.

SOURCE:

https://www.hbma.org/news/public-news/n_chasing-self-pay-revenue-in-emergency-medicine