Palmetto State News 2018-2019 Issue 1 - Page 11

Patient responsibility that is not collected prior to discharge leads to an increase in patient statements generated, increased workload for early-out staff, and in many cases an increase in fees paid to early-out business office vendors.

5. Partner with an eligibility provider that has a flat monthly fee model.

Too many providers pay eligibility vendors on a fee-per-transaction basis, or have entered into an agreement that limits the number of monthly transactions and imposes costly overage fees. This model is extremely challenging: 1) It is difficult to budget for when your organization is querying multiple payers to find insurance; and 2) Its high cost limits staff’s utilization of the system, leading to un-verified insurance coverages and costly back-end payment recoveries. Partnering with a vendor that offers a flat monthly rate ensures that staff can verify eligibility without limits at a pre-determined cost that is easy to budget for.

In order to accelerate the revenue cycle, you must receive prompt payment. But, this means great care must be taken to ensure you have processes in place to ensure eligibility up front to avoid the delay and expense of having to collect at the back end.