HOW TO CORRECT UNDESERVED COLLECTION PROBLEMS
Systems 4PT recently announced that collections per claim were even, comparing the 12-month period July 1, 2017 through June 30, 2018, with the same period one year earlier (July 1, 2016 through June 30, 2017). In addition, most practices experienced an increase in collections per claim January-June 2018 vs. the same period in 2017. This analysis was based on practices with at least 24 months experience using Systems 4PT’s EMR/RCM. Chris Adams, Director of Communications, noted, “Our FOCUS practices have not seen a decline in average collections per claim since 2013 levels, when we began measuring this stat.”
From Systems 4PT’s perspective, the state of outpatient rehab in 2018 is strong. But if that’s the case, why are other EMR/billing solutions warning of declining reimbursements and asking if rehab is on the brink of recession? The answer is simple: Some approaches work better than others. The good news: The approach you take –one that delivers strong collections, or a different approach that results in declining collections — is entirely your decision.
ANALYZING THE DETAILS
For many, the performance cited above seems counterintuitive, if not impossible. We’ve all seen examples of declining contracted payer rates. And we all know that the percentage of payer reimbursements have declined while patient obligations have increased.
There is no doubt that certain payers’ contracted fee schedules have declined over the years. But concurrent with this, Systems 4PT has developed proprietary collection technologies that have increased reimbursements by 1.4% here, 0.6% there. Year by year, our technologies have offset the declines in contracted rates for our practices. No single improvement has “fixed the collections problem.” The combination of dozens and dozens of proprietary, incremental increases have kept our practices’ collections strong and stable. It’s obvious that no other EMR is as focused on this philosophy of “constant Improvement.”
There is also no debate that patient obligations such as coinsurance and deductibles are higher today than ever before. Practices must get better and better at collecting these balances on intake. And unlike shifting payer rules, collecting patient obligations is completely under your control, assuming your EMR allows this to happen.
OUTPATIENT REHAB, AN INDUSTRY OF FINANCIAL WINNERS AND LOSERS
You can find financial winners and losers in every industry. Financial success or failure is often the result of the different approaches and tools people choose to use.
Example: Did you know that the largest EMR in outpatient rehab does not communicate patient coinsurance or deductible balances due to front desk staff during patient intake? While claiming that, “billing is integrated,” the EMR and billing modules are in completely separate databases. Calling their billing “integrated” is a very expensive half-truth.
DEFINE WHERE YOU STAND WITH THIS 20-SECOND TEST
Take 20 seconds and ask your front desk staff to show you the coinsurance or deductible due for the next patient who is about to check in. Don’t ask to see copay, ask to see coinsurance or deductible due.
You’ve discovered a fundamental problem: Patient obligations represent an increasing percentage of collections, but you’re working with an EMR that does not communicate patient obligations on intake.
This is why we say, “Your collection problems are self-imposed.” You should not live with this.
Your EMR has not kept pace with payer changes over the years. The most striking examples of this are primitive EMRs that seem to lack the competence to innovate their own billing modules and instead acquire a bolt-on billing system. In an attempt to solve their problems, one such EMR has acquired two different billing systems!
With perspective, you now see that unsophisticated EMR is punitively expensive: As patient obligations skyrocket, your front desk staff can’t collect coinsurance and deductibles on intake because your EMR doesn’t communicate how much the patient owes.
IT’S NOT SURPRISING THAT YOUR COLLECTIONS ARE DECLINING
The big surprise is that your EMR is the culprit.
THE WRONG SOLUTION
Perspective can be hard to find, as your EMR surrounds you with slick communication that makes it easy to blame declining payments on a sagging industry.
We urge you to hone your perspective, be leery of marketing messages that “rationalize” declining reimbursements. Recognize that these messages are designed to make underpaid therapists feel “normal.”
Take a fresh look at what’s going on: The typical outpatient rehab practice is flat-out busy. “We would hire another therapist if we could find one.” Against this backdrop, underperforming EMRs now claim to have the answer, “Our new program will increase patient volume, which will increase cash, which will solve your problems!!!”
This is the wrong solution. Your EMR assumes you’re too busy to ask the obvious questions:
- We’re treating at capacity. I can’t find new therapists. What good are more patients?
- We’re not collecting the money due for our current patient caseload. Instead of adding more to a leaky workflow, why don’t we fix the workflow? If we collected what’s already due, we would be rolling in cash. Why don’t we fix that problem?
There’s little more insulting than a vendor who’s letting you down (by not maximizing collections) who claims to have the solution (for a significant add-on charge), all the while trying to avoid the fact that they’re not collecting what’s already due.
Welcome to your new perspective.
SELF IMPOSED – NO MORE
The GREAT news is that “You’re the Boss.” You’re in charge.
You can’t allow your EMR’s limitations to further weaken your practice, no matter how soothing their marketing… Particularly when technologies exist that have demonstrated the solution.
We are not recommending rash decisions.
We are recommending a shift in perspective that recognizes, “If collections are stable for thousands of practices, then there is no reason why I should accept continually declining reimbursements.”
And then we are recommending research.
Take a look at our video, “The clearest explanation of why you’re not getting paid.”
Take a look at our System Overview Video – an abbreviated system demo.
You will see the specific workflows that have delivered strong, stable collections in 2013, 2014, 2015, 2016, 2017, and 2018. You will see many of the proprietary technologies that Systems 4PT has developed. Rather than rationalizing failure, you will recognize tactic after tactic that increase collections, but aren’t available with your EMR.
You deliver A+ patient progression. Why do you accept a C+ EMR/billing system?
As patient obligations increase, why do you accept working with an EMR/billing system that doesn’t communicate patient obligations on intake?
Stop accepting your EMR’s depressing version of financial “normal.” Raise your sights. Expect to get paid what you’re worth.
Let’s work together and get you properly paid for the great work you do!