Quality payment solutions in healthcare are essential for medical practices. Billing, insurance claims, and payments can present significant challenges. Overall, the healthcare industry in the US loses $935 million per week due to billing errors, which are most often incorrect coding or mismatched patient data.
The loss figure does not include late or incomplete payments, usually due to patients who choose to pay by sending a check in the mail or opting for a payment plan. Even if these payments come through in time, processing is often ultimately delayed.
Integrated payment processing can streamline medical billing and reduce record-keeping errors that complicate insurance claims. These payment solutions for healthcare practices incorporate patient billing data and records along with payment processing into one platform.
A singular source for billing information allows patients to make payments and track claims through a patient portal. It also allows for the transfer of codes and records for accurate billing.
In this article, we’ll discuss the importance of a streamlined financial management system and the challenges healthcare practices face with payment processing. We will discuss how integrated payment solutions can address these problems. Finally, we’ll share tips for adopting better payment solutions in your healthcare practice.
RELATED ARTICLE: Avoid These Top 5 Medical Billing Mistakes
The Importance of Efficient Healthcare Financial Management
For decades, patients paid co-pays and medical bills with cash or checks either in person or by mail. These payment methods were cumbersome and unreliable. Eventually, accepting electronic payments by credit and debit cards expedited payments and processing times.
The introduction of online payment solutions streamlined the process further.
Patients can now make payments from virtually anywhere with an internet connection. It’s in the best interest of practices to integrate payment processing into patient portals, allowing patients to log in and pay at any time.
Streamlined payments and integrated financial systems make billing more convenient, but the benefits for healthcare practices go beyond getting paid on time.
Here are other advantages of having efficient payment and financial management:
Improved Revenue Cycle Management
With integrated payments processing, patients can enter insurance and payment information during registration. Billing staff can then refer to this information to verify coverage for specific treatments. Patients can also view balances owed and make payments immediately. These advantages make it possible to manage the entire revenue cycle in one place.
Better Data Security
Practices must comply with HIPAA data security regulations or face professional censure. Ensuring total compliance is easier with one efficient and centralized system. Providers will not have to monitor security in separate billing and practice management platforms or be concerned about keeping billing information secure when transcribing it.
Enhanced Efficiency
With integrated billing and payments systems, providers can store all necessary patient billing data in one location. Billing specialists can easily access data necessary for insurance claim submission, and providers can alert patients about potential coverage issues or offer information on the costs of specific treatments.
Increased Coding Accuracy
Incorrect medical coding can lead to billing confusion and declined reimbursements. An integrated system can limit the need to manually reenter codes, thus improving accuracy. Embedded codes eliminate typos or data entry mistakes, ensuring claim acceptance and accurate patient financial responsibilities.
As soon as a bill is distributed, a patient can confidently pay it, knowing it is correct. Overall, efficient financial systems limit or eliminate problems that cause payment delays, positively affecting cash flow and profitability.
RELATED ARTICLE: 5 Effective Ways to Improve Patient Collections
Challenges Faced by Healthcare Providers in Payment Processing
Efficient financial management can help position a practice for success, but specific challenges related to payment processing still need to be addressed. These potential barriers can cause payment delays or prevent compensation altogether.
Here is a review of the most common payment processing challenges in healthcare:
Claim Denials
Healthcare insurance claims are denied for various reasons, including incorrect coding or lack of supporting documentation. Some insurers may refute treatments that are deemed medically unnecessary.
If claims are denied for any reason, you won’t get paid, though it may sometimes be possible to make corrections and resubmit the claim. The resubmission process costs valuable time and resources.
Managing Multiple Payers
Sometimes, claims are split between different insurers, depending on the nature of the claim. Different payers may have different requirements, which complicates payments and increases the chances of errors or denials.
The patient is also typically required to pay a deductible for each insurer, complicating the process even further.
Payment Collections
Patients may have to pay some or all of their medical bills, but they may be unwilling or unable to do so. Practices may have to hire collection agencies to pursue payment or create payment plans to assist patients with the bills.
There could be lengthy delays in these cases until full payment is received. Collection agents may also require a portion of the payment, decreasing reimbursement.
Payment Processing Delays
You may experience payment processing delays with any payment type. There may be insufficient funds to make a full payment, or a bank or credit company may hold payments while checking for fraud.
Payment processing systems can sometimes lead to data security breaches. Practices can be held liable for HIPAA noncompliance, resulting in fines, loss of reputation, and even criminal charges. Processing systems must also meet the Payment Card Industry Data Security Standard (PCI DSS) to accept card payments.
Patient Confusion
Some patients may be confused about co-pays or deductibles or unaware that their insurer does not cover specific procedures, leading to payment avoidance. They may also be unable to pay when confronted with unexpected out-of-pocket costs.
Some of these challenges are inherent in payment processing, but you can take steps to limit their impact and lower the likelihood that they could occur.
FROM ONE OF OUR PARTNERS: Patient Engagement & Its Importance in Healthcare
Integrated Payments Processing in Medical Billing
Medical practices have different payment processing options depending on the size of the practice and the type of services offered. Other factors, such as co-pays, can also be important.
Here, we’ll investigate the common payment processing options for healthcare providers, considering the advantages and drawbacks of each.
Point-of-Service Payments
Point-of-service (POS) terminals are useful when patients want to pay in person, especially in the case of co-pays. POS systems are also common in clinics that sell products, such as an optician selling eyeglasses onsite or a hospital with an onsite pharmacy.
Pros: POS systems collect payments immediately, eliminating the need for additional billing tasks. Providers will not have to spend time billing patients for small amounts.
Cons: POS systems require installing and securing additional hardware, and they are not a stand-alone solution. POS payments must integrate into a larger billing platform.
Patient Portal Payment Integration
Payment processing can be a function of your patient portal, allowing patients to pay online with a credit or debit card anytime. Some options may also facilitate ACH transfers and other electronic payments.
Pros: There’s a higher level of security using this payment processing system because it is integrated into your patient portal platform. This option is often the most convenient for patients. They can view bills and balances and make payments at any time.
Cons: Patients without internet service won’t be able to use this system. Also, practices must pay the initial expense of adding the system to their platform.
EHR-Connected Solutions
Some integrated payments systems can work in tandem with electronic health records (EHR) platforms, allowing you to see coding and billing information. These dual systems are useful for verifying coverage, preauthorizing claims, and clarifying out-of-pocket requirements.
Pros: This option improves transparency for patients. They can preserve billing information using existing patient history, reducing administrative paperwork and errors related to manual data entry.
Cons: You might encounter compatibility issues during integration. Staff may also need to undergo supplemental training to learn how to use the new system, which can lead to an adjustment period.
In the end, providers may need to combine several solutions. For instance, providers will need to accept payments from health savings accounts (HSAs), and some patients may still prefer cash or check payments. Providers will need to plan to accommodate these payment methods as well.
FROM ONE OF OUR PARTNERS: 4 Ways Online Patient Payments Can Transform Your Practice
Top Takeaway Tips for Healthcare Payment Solutions
An integrated healthcare payment solution can streamline financial processes and address some of the complications that cause payment delays or non-payment. However, these benefits are only pertinent if you account for and adjust for the challenges related to payment processing.
Here are actionable steps you can take right now to begin your search for a payment solution:
Define Your Needs.
Consider the size of your practice and calculate the number of transactions you handle daily to help you decide on the type of system and features you need. For instance, if you process a lot of in-person co-pays, you will need POS terminals.
Consider Your Budget.
You may need to make an upfront investment to integrate the payment system, but you should also consider ongoing costs. Recurring costs can include monthly subscription fees and transaction processing fees. Estimate how much you can afford to pay for each of these costs.
Educate Yourself About Compatibility Requirements.
Research the compatibility requirements for your existing patient portal and EHR platforms. Your payment processing solution should fit these requirements for smoother integration. More importantly, ensure the integration will not introduce new security vulnerabilities.
Consider Demos.
Payment processing providers may allow you to test their solutions or offer a guided walk-through of their features and functionality. Solutions like CollaborateMD offer demos that allow you to examine the tools closely to ensure they meet your requirements.
These steps will help you find the best payment solution for your healthcare practice. It can help simplify your billing processes and reduce errors and delays.
