Even under the best of circumstances, it can be difficult to collect payments from patients. Factor in the complexity of the healthcare revenue cycle and it is only natural that errors will happen, thus compounding the challenge of receiving timely payments. Healthcare organizations can mitigate the extent of these errors by self-monitoring with quality assurance questions that anticipate where problems are commonly introduced.
Questions to ask the patient
Can you please confirm the accuracy of the following information?
- Patient’s full name
- Patient’s date of birth
- Patient’s billing address
Let’s start with the basics. It’s best not to underestimate the damage a simple clerical error can do. Even if the information was always entered accurately, it doesn’t mean it still is accurate. Patients move, and name changes are common, especially when patients have a change in marital status (which may prompt the next question, as well).
Has there been a change in insurance coverage?
This question is so important it is usually included as a column on the patient sign-in sheet. It is essential that the insurance information on file be up to date for accurate insurance validation, payment estimates, and pre-authorization.
Is the payment card on file still the preferred method of payment?
Even if the patient is seen on a frequent basis, the payment method is still liable to change at any point. Patients payment cards will need to cycle out of service as the expiration date approaches, but there are several reasons why the payment method may need to change before that point. A credit card may reach the limit, or a health savings debit card may finally drain the account.
Questions staff should be asking themselves
Do I know information that the patient doesn’t, but should?
This will prompt a range of questions that will vary from one patient to the next. Many patients are confused by the healthcare industry and do not understand their medical bills or insurance coverage. The patient may be unaware that they are carrying a balance. Have they met their deductible? Or perhaps the physical therapy patient only has two more visits that will be covered by their insurance plan. Sharing information, as appropriate, can help manage patient expectations, which in turn leads to improved patient satisfaction.
Has this patient encounter been coded correctly?
Staff should always doublecheck their work before submitting a claim. Do the diagnosis and treatment codes match? What about the setting? Ensure that the coding matches the services provided to this patient and that nothing is missing or duplicated — neither upcoding nor undercoding the patient encounter. By anticipating a few areas where problems tend to arise, healthcare organizations can provide better service to patients and increase patient satisfaction rates. Of course, the benefit extends beyond customer service: when errors are eliminated, collections improve.