Getting paid for out-of-network patient services is more difficult now than ever before. It is projected that 95% of your patients will fail to fully pay for their medical bill balances by 2020 (alarmingly, this is up from 68% in 2016 and 49% in 2014)1.
Whether you choose to be out-of-network, or the payer drops you as they narrow their provider network, the result is the same – you are at the mercy of your patients to pay a larger and larger portion of their medical expenses. Even when you do get paid, it typically takes longer and can cost you four times more than when you receive payment directly from a payer you contract with. However, there is something you can do about it….
By making a few easy-to-implement modifications to how you manage your out-of-network patients, you can significantly improve the reimbursement you receive. This is where practice management expert and consultant, Owen Dahl, LFACHE, CHBC, LSSMBB, can help by showing you exactly how to significantly improve your out-of-network payments - from both patients and payers.
During his online training, Owen will walk you through what you and your staff can do to get more of your out-of-network patients and carriers to pay faster and at less cost to your practice.
Here are just a few of the practical, plain-English out-of-network reimbursement tactics you’ll receive from this expert-led 60-minute online training session:
- Utilize proven markers to quickly identify which out-of-network patients to accept and which to turn down
- Clearly communicate your patient’s financial obligations so there are no surprises
- Balance bill patients for the unpaid amount due, something in-network physicians can't do
- Implement proven payer negotiation strategies to get your claims paid
- Avoid legal pitfalls for managing existing patients that transition to out-of-network plans
- Improve patient satisfaction with key communication strategies that work and get you paid
- Boost revenue by determining if your state has mandatory assignment of benefits
- Utilize the right assignment of benefits language to get you paid directly from out-of-network payers
- Avoid Medicare billing violations that can lead to you being disengaged as a provider
- Get patients to forward insurance payments they receive to you without hesitation
- Don’t be pressured into signing a single-case agreement that only benefits the payer
- Utilize proven phone strategies to get what you want from network payers
- Avoid third-party portals that don’t allow you to negotiate, so they can pay you less
- Pin down if patient-payer contracts have strings attached that stop you from getting paid
- Negotiate favorable terms with payers and make seeing out-of-networks patients more profitable
- And so much more…
Who is this for? This online training is directed toward practice managers and financial managers from all sizes and specialties of outpatient practices. Also, physicians and NPPs interested in understanding how to bolster payments from out-of-network patients and payers may also find this training helpful.
Accepting out-of-network patients (both from Medicare and private payers) can generate a significant amount of revenue for your practice IF you know how to combat the numerous obstacles you must you must overcome to get paid. By knowing the challenges of out-of-network reimbursement, you can better manage its risks and expectations, and lessen the probability of having to excessively chase your payments, or not receive them at all.
Don’t make the mistake of thinking you should turn away all out-of-network patients. You can accept many of these out-of-network patients and get paid adequately for the services you provide. But only if you successfully set up the proven processes that you’ll learn during this online training. Don’t wait, sign up for this training today.
- Source: Patients May be the New Payers, But Two in Three Do Not Pay Their Hospital Bills in Full, TransUnion Healthcare, June 26, 2017
Meet Your Expert: Owen Dahl, LFACHE, CHBC, LSSMBB
Owen is a principal of Owen Dahl Consulting, in The Woodlands, Texas. He has 53 years of experience in consulting, running a medical billing service and managing medical practices. He was also a hospital administrator. Owen speaks across the country on medical practice issues related to strategic planning, Lean and Six Sigma, culture, human resource management and the revenue cycle.
He is an adjunct professor at the University of New Orleans, the author of Think Business – Medical practice quality, efficiency and profit, contributing author of the popular book Lean Six Sigma for the Medical Practice and recently published Integration of Behavioral Health Into Medical Homes: A Rapid Implementation Guide. Owen received his Bachelor’s degree in Hospital Administration at Concordia College, Moorhead, MN and his Master’s from the University of Northern Colorado. He recently achieved his Lean Six Sigma Master Black Belt through Villanova University. He served in the USAF.