For those health care practitioners who want to reap the benefits of automating their account receivable (AR) processes, we offer here a few tips on how to make this transition from paper invoices and bills to streamlined digital AR functions and operations.
Manual AR still constitutes an expensive financial loss for some providers, and while they may want to change things, many don’t know where to start. Just some of the disadvantages of resorting to manual processes in AR include the staffing needed to process bills and issue invoices and to follow-up with customers and patients, the operational burden represented by delays, repeated calls to bad payors, misplaced checks, trips to the post office and in-person deposits at the bank, the lost chance to recover owed amounts when an employee forgets to issue or mail an invoice and the subsequent loss in cash or idle liquidity.
Where to start
The first step to convert is to identify any regulatory restrictions or requirements for your type of business. For a medical practice, HIPAA remains the overarching law. In that case, even though “using payment processors does not fall under the HIPAA regulation, invoicing and billing needs to comply with HIPAA requirements”.
Not all software programs or payment platforms are HIPAA-compliant. As long as you can password-protect your files, you can even issue invoices in Word or Excel. But once you list the payment options on the invoice, you must verify that they’re all HIPAA compliant. For instance, Quickbooks and Paypal, for all their practicality and reputation, are not. Those which are HIPAA compliant usually have a blue HIPAA badge in the processor’s profile on their website. However, it’s always advisable to confirm with them before signing up.
As you choose a HIPAA-compliant medical accounting program, there are several criteria you need to consider: the features of the program such as patient registration and scheduling, automated coding and claim management, credit card payment and reporting, and criteria like business support which includes training offered to employees, tech support when problems occur, spam filters and other security and encryption protections, and more.
Making the transition
Normally, once you have acquired an EHR solution and or/payment processing platform, it’s relatively easy to introduce new customers to it from the beginning: either when they set up their first appointment or when the patient intake is done. It’s the old customers you’ll be having problems with.
For those with an existing patient chart, the process will entail heavy scanning and data entry. It’s best to start with patients who have already scheduled future appointments. You can also ask your IT provider for advice on how to digitize records quickly and efficiently. Spacing outpatient appointments, where possible, should give your staff enough time to convert the information and to receive the training they need.
Facilitate patient adoption of the new system
One of the obvious challenges to paperless billing is the reluctance of your patients to sign up for online notifications or download your app. You’ve converted your billing system, how are you going to convert your customers?
Be mindful of your demographic. Millennials are much more likely to use technology and prefer e-billing. People in their 50s and above may feel more comfortable with paper invoices. Try to be sensitive and flexible. Offer to train the patient or even offer a financial incentive like a discount in order to get them to sign up for paperless billing. Make sure to obtain each patient’s signed authorization before switching them to electronic invoices. If your software or portal presents the bills in a completely different way from the paper bills, you can try to format your paper bills first, so they match the electronic version as closely as possible and the patient can get used to the new format. Later, the patient is introduced to the electronic bill which they’re already familiar with.
Third-party billing specialists
Here are some examples of popular payment providers:
- BillingTree offers strong patient data security and is HIPAA compliant. Their CareView solution includes POS payments, web and online portals, credit and debit, and even text payments. While BillingTree doesn’t advertise its prices on its website, you may request a demo and then obtain a quote. For more information, you may contact them directly or read this review.
- Chase acquired FisaCure in 2007, a “leading provider” of HIPAA-compliant payment solutions. Formerly known as Chase PaymentTech, Chase Merchant Services has been known as one of the most efficient and reliable B2B service providers. While this is another provider who chooses not to display its prices on their website, you can find some information here or fill out a ‘contact form’ on their website.
- Instamed, a JP Morgan company, advertises a comprehensive set of tools for health care providers. Among other services, they offer Instamed Online for Payers which “seamlessly integrates with payer systems”, providing payment capabilities to your existing system. As with the aforementioned providers, their prices are also not displayed on their website.
- Payline declares a low-cost, affordable solution for health care providers, with transparent pricing and no long-term contract requirements. Some of the fees are displayed on the website, but for customized services and final prices, you have to contact them.
- Kareo’s flexible and comprehensive set of tools is specifically designed for “your independent practice, not for a hospital”. They offer help with the digitization of paper records and conversion to electronic billing, plus free coaching for the first 60 days once you sign up for one of their packages. Kareo also requires direct contact for accurate pricing, but some information is available on Investopedia.
As part of your ‘best practices’ guidelines, before you commit to any technologies, you have to make sure you understand the billing process. Even if you start with password-protected invoices in your MS Suite or with issuing paper invoices, having a clear idea of how billing works will help you identify where you’re losing cash and how you can adjust your processes to collect. Physicians and coders have to be on the same page and stay knowledgeable about insurance claims as well as what the patients themselves have to pay: copayment, coinsurance and deductibles. When an insurance company rejects a claim or only partially covers it, the balance gets transferred to another insurance carrier or to the patient. Promptly following up and obtaining at least partial payments as soon as possible, hopefully before the patient’s next billing cycle and appointment should be a priority for any billing system.