How to Improve Out-of-Network Patient Balances?

As a healthcare provider, collecting patient balances can be challenging and time-consuming. This is especially true in out-of-network scenarios where the payer sends funds directly to the patient, leaving healthcare providers to navigate a complex and often frustrating process. However, with the right strategies and tools, healthcare providers can overcome these obstacles and improve patient collection. In this blog post, we’ll explore overcoming the obstacles of collecting patient balances in out-of-network scenarios and improving them for streamlined patient collections.

Understanding out-of-network patient balances

Out-of-network patient balances are balances owed by patients to healthcare providers when the provider is not in-network with the patient’s insurance plan. These balances can arise for various reasons, such as a patient receiving care from a specialist not in their insurance network or seeking care at an out-of-network facility. Out-of-network balances can be particularly challenging to collect because they are often higher than in-network balances, and patients may not expect them.

Healthcare providers should know the common reasons for out-of-network balances and how they impact revenue generation. Providers should also be prepared to deal with payer policies and patient behaviors that complicate collections.

How to Overcome Obstacles in Out-of-Network Patient Balances

Set clear expectations and communicate with patients

One of the most effective ways to overcome the obstacles of collecting out-of-network balances is to set clear expectations with patients upfront and communicate effectively throughout the collections process. This means explaining the costs of out-of-network care in writing and discussing payment options and plans with patients before treatment. Healthcare providers should also send periodic statements and reminders to patients and offer payment incentives or discounts for prompt payment.

Effective communication with patients is key to maintaining a positive relationship and ensuring that balances are paid on time. Healthcare providers should be upfront and transparent about costs and billing procedures and try to address patient concerns or questions promptly.

Utilize technology to streamline the billing process

Technology can be a powerful tool for healthcare providers to streamline billing and improve patient collections. Electronic statements and payment options can make it easier for patients to understand their bills and pay balances promptly. Patient portals allowing self-service billing and payment can also improve patient collections.

Automatic payment reminders and follow-ups can also ensure that balances are paid on time. By automating the collections process, healthcare providers can free up resources and reduce administrative burdens.

Consider outsourcing to a medical billing company

Outsourcing to a medical billing company can be an effective strategy for healthcare providers to overcome the obstacles of collecting out-of-network balances. Medical billing companies have expertise in navigating payer policies and regulations and can provide dedicated resources for patient collections. Advanced technology solutions for billing and payment processing can also help improve patient collections.

Outsourcing to a medical billing company can also help healthcare providers reduce administrative burdens and focus on patient care. Healthcare providers can see increased revenue and improved patient collections by working with a reputable medical billing company.

Stay up-to-date on regulations and policies

The healthcare providers must stay current on out-of-network patient balance regulations and policies. The No Surprises Act, for example, is a recent federal law that protects patients from surprise medical bills and limits out-of-network charges in certain situations. Healthcare providers should be aware of these regulations and policies and ensure their billing practices comply.

Collecting patient balances can be complex and frustrating, especially in out-of-network scenarios where the payer sends funds directly to the patient. However, with the right strategies and tools, healthcare providers can overcome the obstacles of collecting out-of-network balances and improving patient collections.

Collecting Out-of-Network Patient Balances: How BellMedEx Can Help?

Expertise in Navigating Payer Policies and Regulations

BellMedEx has experience working with various payers and their policies, enabling them to provide expertise in navigating payer policies and regulations related to out-of-network patient balances. Understanding these regulations is crucial for improving patient collections and revenue generation.

Advanced Technology Solutions

BellMedEx offers advanced technology solutions to improve patient collections, including electronic statements, payment options, and automatic payment reminders. These solutions can improve efficiency and patient satisfaction while overcoming the obstacles of collecting out-of-network patient balances.

Dedicated Resources for Patient Collections

BellMedEx provides dedicated resources for patient collections, allowing healthcare providers to free up resources and focus on patient care. Having specialized resources to address patient balances is essential for improving revenue generation and patient collections.

Conclusion

Collecting patient balances in out-of-network scenarios can be challenging, but healthcare providers do not have to face these challenges alone. By partnering with medical billing company, healthcare providers can improve patient collections, revenue generation, and focus on patient care. Understanding the challenges of out-of-network patient balances and partnering with BellMedEx can help healthcare providers overcome these obstacles and improve patient collections.