January 1st will bring annual deductible resets, which leads to a predictable drop in revenue for many providers. However, 2021 may be significantly more challenging than years past.
Deductibles will again be on the rise, with the median individual deductible for a healthcare.gov bronze plan rising to $6,992 in 2021, compared to $6,755 in 2020. Employer plan deductibles averaged $1,500 for individuals and $3,000 for family coverage in 2020 and are expected to remain roughly the same in 2021.
According to the Robert Wood Johnson Foundation, more than 10 million people may have insurance coverage disruptions due to the COVID-19 pandemic, with 3.5 million losing insurance completely. And, a survey published in January 2019 revealed that only 40% of Americans had enough cash in savings to pay for an unexpected $1,000 expense. Given the pandemic's financial consequences since that time, that percentage has most likely dropped well below the 2019 level.
With patients bearing more responsibility for providers’ reimbursement than ever before, what can organizations do to protect their revenue during the first quarter of 2021? Here are our top five tips to keep cash flowing.
Although this tip may sound like common sense, even small practices can have a surprising amount of unresolved or unpaid claims. Track down all unpaid claims, confirm appeals are submitted, and encourage providers to supply any outstanding information needed for claims submission. All outstanding claims and appeals for 2020 should be sent to payers by the end of the first week in January; this should boost revenue at the end of January and beginning of February when many new outstanding balances will be deductible amounts.
Our GlacePremium customers benefit from year-round outstanding balance follow-up as well as constant monitoring of unsubmitted claims to ensure maximum revenue capture throughout the year.
Be alert to 2021 diagnosis and procedure coding changes. Analyze the coding updates that will affect your practice and set scrubbers to new coding conventions starting for the January 1st date-of-service. Confirm your office staff is aware of new and deleted codes, and new documentation requirements to support coding. If coding is done correctly from the beginning of the year, there will be no interruption in reimbursement from payers, and patients can be billed promptly for outstanding balances.
With GlaceComplete, coding updates are automatically uploaded into your practice management software throughout the year. Our team of experts monitor CPT and diagnosis coding as well as changing requirements associated with NCDs and LCDs – saving time and labor for your practice.
During the first quarter, it is critically important to watch for new denials. Frequently, denials at the beginning of the year are the result of unrecognized coding changes. Pre-scheduled weekly meetings allow your organization to make the operational or documentation changes required to stop their flow before they interrupt payments and drain labor.
The GlacePremium team quickly identifies, analyzes, and corrects new year denials and implements strategies across your organization to prevent future disruptions to cash flow.
Many patients who don't pay their medical bills often claim they don't understand them. Take a fresh look at your statements and see if any improvements can be made to language or format. For example, rather than calling an amount coinsurance, consider changing it to ‘your share’ and highlighting the amounts owed. Another useful exercise is to get input from staff that handles billing questions. They will be able to tell you the most common complaints and probably have some ideas about how to solve issues.
Glenwood Systems implements best practices across-the-board to optimize revenue and increase collections, including easy-to-understand statements, live representatives to answer patient questions and convenient patient payment options.
Providing easy and convenient payment options to patients can be the difference between a bill paid and a bill ignored. Confirm your statements clearly instruct how to make online payments. If you are not already offering a payment plan, investigate your options. Some software and RCM applications automate payment plans, so very little (if any) office administration is required to keep payments coming in.
We provide constant monitoring of past-due balances for GlacePremium practices. Our patient services representatives call long-pending accounts to facilitate payment by setting up a payment plan or taking a credit card payment over the phone.
There is one central idea to keep in mind when getting ready for the cash dip of Q1 – preparation. Proactive changes to workflows and technology before the new year will keep revenue from slipping and put your practice in the best position for a financially successful 2021.
Interested in how Glenwood Systems can help your practice reach its revenue goals in 2021, or how to employ our top tips? Visit us at glenwoodsystems.com or call (888) 452-2363.