Improve HME Cash Flow in Deductible Season

HME billers: Are you feeling a need to improve HME cash flow?

Every year, most providers face the same freeze that begins mid-January: deductible season. As deductible season seems to run deeper into the year, HME providers are depending more on secondary and patient payments than ever before. Using more modern, collection-focused habits in your revenue cycle management can help you soften the hit on your cash flow in the first quarter of each year. We outline a few strategies here that we have seen work well in the past. Hopefully, they will help you improve collections through your deductible season!

As we all know, the HME billing claims process is quite complicated. It can be even harder to collect patient dollars when traditional approaches to managing revenue cycle simply don’t leave much wiggle room. But there is good news!. The shift to greater patient responsibility means that your patients are more willing now than before to offer up payment as a supplement to your reimbursements.

1. Offer a discount for patients that pay now on last year’s balance.

A recent study released by Athena Insight showed physician practices collect 40 percent of outstanding balances when the tab is $35 or less, but just 6 percent of such balances when the patient’s debt tops $200. We’d have to guess that numbers are similar in our end of healthcare.

These smaller balances should be simple to identify inside your existing accounts receivables (AR) and we suggest you call the patients to find out what you can collect now. Start with November 2017 and work your way backward. If your team members are met with objections, empower them to offer discounts to settle the balance. Set a maximum discount rate so they can clearly understand what they are authorized to offer the patient.

Make it an internal challenge to clear this old AR off your books and boost your cash flow by incentivizing employees on collections. In addition to checking with your payor’s rules, we advise setting a couple of ground rules with this strategy:

Set a start and stop date for this amnesty period. There is no shame in collecting past-due patient balances, but we do not suggest that you create a culture in your company that provides permanent amnesty or encourages anybody to delay co-insurance payments. Our suggestion is a 60- or 90-day push, once or twice a year.

Create an affordable and simple incentivization program for teams to contact and process deductible and coinsurance payments. It could include a coupon for a lunch away from the office or a gift card to a local coffee shop. Regardless of what you choose, it is essential to track and celebrate progress publicly.

2. Hunt secondary AR as aggressively as you do primary claims.

2018 is the Year of the Dog according to the Chinese zodiac which suggests a time of stability and groundedness. We suggest you embody this in your business by starting to process as many secondary claims as soon as you can, reporting on them separately in billing review through the end of the second quarter.

An additional benefit of chasing down those secondary insurance claims is the deeper understanding of adjustments made in your AR. That insight can be vital to identifying deficiencies around the entire company. Reporting on these adjustments separately can be beneficial as well because these metrics help you understand how well your team is processing claims.

3. Require automatic payment information on file for all recurring rental orders.

This one is a clear and simple workflow adjustment: no automatic payment information on file means no delivery. There are various options in the market to safely store payment information and charge patients for their recurring co-insurance. We suggest you use one of them and Prochant can make suggestions if you’d like – just contact your Account Manager.

If all else fails you can even process the charges manually, however, you’ll need to be diligent to have the patient’s permission every time you do so. Get their signature at the time you deliver the product and pay attention to credit card security and compliance standards.

4. Hold your Medicare claims until deductibles have been met.

This strategy might take a little preparation prior to the end of the year because you need to make sure you have enough cash reserves prior to making the commitment. Check with your software vendor as part of your planning and preparation – most of them have a simple solution to help with this strategy.

Now a word of caution before you get started on any of these strategies. Prochant has found that specific payors can sometimes have rules that may impact some of the ideas presented in this article. So make sure to do a quick check of your agreement with each payor before rolling out any strategy that might impact your claims processing.

And remember that your challenges are not unique. There is an entire industry of HME providers who are going through similar challenges! When in doubt, it is always best to pick up the phone and talk to another provider you may know. And, of course, Prochant experts are always eager to provide insights on industry best practices.

Prochant is the nation’s leading HME billing and process outsourcing company. Our highly-skilled team helps providers become more profitable by outsourcing or enhancing front- and back-office processes. We rapidly implement changes and proactively monitor metrics to ensure client success. Headquartered in Charlotte, North Carolina, we work with top medical equipment providers and health systems.