Self-Pay Patients are Effecting Your Bottom Line and Decreasing Your Revenue

There has been much debate and scrutiny over Obamacare, leaving many Americans with unanswered questions pertaining to their insurance coverage and their options. But what about the providers? Historically healthcare providers and provider organizations are use to grappling with Medicare, Medicaid and insurance companies for claim reimbursement, but now there is another wrench in the works with the dramatic increase in self-pays. Many providers are struggling to keep up with the new unique financial challenges that self-pay claims create and identifying these patients prior to rendering service and accurately collecting their payments before exiting the office after the encounter. Studies prove that once a patient exits the office without paying their balance that the money owed has a very high likelihood of becoming bad debt. Between 2008 and 2012, multispecialty practices saw their bad debt go up 14 percent, according to a survey by the Medical Group Management Association (MGMA), a trade organization for doctor practices. That’s money that practices were owed but couldn’t collect. Some of them have begun to change their billing strategies to combat those debts, says Ken Hertz, a principal consultant with the MGMA Health Care Consulting Group.

There are solutions, by either outsourcing to a early-out billing company, using price transparency software or by implementing new practices and standards in your office, EHR & Practice Management Consultants, Inc. ( can assess your practice to better understand which of these options is the best solution for your Practice. We can offer creative solutions to help patients meet their financial obligations and thereby increasing your cash flow and revenue stream. Let us help you by contacting us at 1-800-376-0212 or

Price Transparency Software Beneficial to Medical Practices/ Clinics

Due to statistics published there is a rising trend of out of pocket expenses for patients due to the growing high deductible health plans for consumers.  In a recent research study by InstaMed in 2013, the annual number of patient payments to providers rose 72 percent between 2011 and 2013, and the average payment of $110.86 in 2011 increased 20 percent to $133.15 in 2013.

America’s Health Insurance Plans, a payer trade association, expects out-of-pocket expenses for insured patients to rise from $250 billion in 2009 to $420 billion by 2015.

Due to the increased out of pocket expenses of patients, providers increasingly are offering payment plans; InstaMed’s data shows that the number of annual transactions for payment plans increased by 284% (percent) from 2011 to 2013.  Additionally, more providers are accepting credit card-based electronic payments online and more patients are willing to pay this way. In 2013, credit card payments represented 42 percent of the gross dollar volume of back office payments which is an 8% percent increase from two years ago.

An InstaMed survey of providers that complements the data analysis shows 67 percent of patients saw an increase in their payment responsibility in 2013.

Forty-two percent of providers did not know what the patient was responsibile for paying during the visit.  Seventy six percent (76%) said it takes more than a month to collect from a patient and 56 percent pegged collections as the top revenue cycle concern.

Another survey found of more than 200 consumers found that 72 percent of respondents were unaware of their payment responsibility during a visit. Only 2 percent received healthcare bills via email in 2013. When a patient was given the option of how to pay a healthcare bill most indicated they would pay online via a provider, payer or bank Web portal. The vendor reminds providers that mobile devices also can be used to collect payments at the point of service.

An area believed to help lower the amount of time to be paid by a patient would be for the practice to use a price transparency software.  This would allow the patient to know exactly what they will owe for the service they are receiving.  Then, the patient has the option of paying the bill at te day of service or know what to budget for when they leave the office.  Therefore, once they receive the bill at home they may have already set the funds aside to pay for this bill.  Either way price transparency software is very simple to use in a medical office/ clinic and can decrease the days of your A/R (accounts receivable).

If you are interested in seeing how Price Transparency software can help you with increasing your collections in a shorter time interval please contact us at EHR & Practice Management Consultants, Inc (800) 376-0212, 847-322-0139  and  We can show you a demonstration on how price transparency software would work in your practice and see if it would be a good fit for you.