Should You Use Patient Payment Software or a Billing Company?

by | Jun 19, 2022 | Blog | 0 comments

It is unlikely that most doctors got into practicing medicine so they could become billing experts, but for the independent physician, billing is a part of everyday life. It is the only way a practice generates income.

Medical practice billing fits into two broad categories: third-party billing and patient billing. Third-party billing involves remitting bills to the insurance companies to receive payment for services rendered. This is a complicated procedure, but it’s been the primary source of practice income for decades and so there are well developed tools and services available. When an insurance bill is sent out, the practice has reasonable assurance that it will be paid in a timely manner.

Billing patients directly is another process entirely, and it comes with its own headaches. Even patients who have health insurance will usually be expected to pay for some of their medical costs. This may come in the form of deductibles, co-payments, or coinsurance payments. A major difference compared to billing insurance companies is that until recently, a relatively small proportion of practice revenue came directly from patients so there aren’t many solutions available. And a major challenge in billing patients directly is that many of them are not aware of just how much of their medical bills they will be responsible for.

When the bill arrives in their mail and they see the high price tag, it may lead to friction between the doctor and the patient. Sometimes this sticker shock also results in non-payment of the bill. This problem can be exacerbated by the frequently substantial delay between the date of treatment and the date when the bill arrives at the patient’s home.

Why Is There a Delay Between Treatment and Billing?

If more patients understood how healthcare billing actually works, there would be less frustration on their part when a bill arrives weeks or months after a procedure or appointment.

When a patient arrives at the medical practice and receives treatment or attention, all the information about the services that were rendered is gathered, coded, and sent to the insurance company for payment. Once the insurance company receives the bill, they make a determination about how much of it they will pay.

The payment amount, along with an explanation of what they covered and what they didn’t, is then sent back to the medical practice. From here, it is the responsibility of the medical practice to try to make up the difference between the cost of the service and how much the insurance company. They do this by billing the patient.

By the time the medical practice has received the information back from the insurance companies and generated and sent out their own bills, though, weeks or months may have passed since the billed services were rendered.

Dealing with Non-Payment

One of the major problems with billing a patient directly is how to handle the situation if they cannot or will not pay the bill.

When bills are sent to insurance companies, they are contractually obligated to pay those bills unless there is a verifiable reason they should not. If billing and coding are handled properly by the practice, bills sent to insurance companies are virtually guaranteed income.

Bills sent to individual patients are not guaranteed. Whether due to sticker shock, confusion as to the origin of the bill, or a financial inability to pay, many bills sent to customers go unpaid. In these cases, the practice is forced to sell these outstanding bills to debt collectors at a fraction of their original worth just to recoup some of their losses.

Patient Payment Software Doesn’t Deal With Non-Payment Issues

Patient payment software can be helpful to an independent medical practice. Medical billing software makes RCM (revenue cycle management) a more streamlined and efficient process compared to doing it manually. It gives the practice’s staff the basic tools they need to gather data, generate bills, and track those bills. What it does not offer the staff help with are the issues that revolve around patient bills that go unpaid.

Patient payment software may send an alert when a bill goes unpaid, but that is the end of the help it offers to those who must collect unpaid bills. It is still the responsibility of staff members to chase down that money. The process may start with a phone call or email that gently reminds the patient about the overdue bill. If the patient responds, the staff must take down the required information, like credit card numbers, or take the steps to deposit a check.

If the patient responds with an angry phone call demanding to have the reasons for this bill explained, it is a member of the staff who must take the time to talk to them and try to explain the process to a person who may have already decided they are being exploited.

Professional Patient Payment Services Can Help With All Aspects of Healthcare Billing

For the independent medical practice, keeping the examination rooms full is the best way to ensure their future success. Unfortunately, keeping the appointment schedule full leaves little time for other activities, like chasing down patients with unpaid bills. Large healthcare organizations may have the resources to hire a full-time team of billers to deal with it, but smaller independent practices may not have the resources or need for a large in-house RCM team.

A reputable patient payment management company can handle all of the patient billing responsibilities for practice, leaving them free to practice medicine. These companies will generate billing statements, handle outgoing or incoming phone calls about billing issues, process checks and credit card payments, and may even provide patients with online payment options.

Because the staff at these companies are experts in the field of healthcare billing, they understand the careful handling that must be done when trying to collect bills from those who are nearing the end of their lives, from family members after their loved one has passed, and the extra sensitivity that must be given to patients around the holidays. They also know how to maximize the collections rates if the bill must ultimately be sent to a collections agency.

TRIARQ Health Has the Patient Billing Solutions for Independent Medical Practices

TRIARQ Health is a management services organization that specializes in helping independent medical practices to thrive and grow in the modern era of medicine. When it comes to patient billing, TRIARQ offers solutions for all of your patient billing woes.

TRIARQ’s Patient RCM and Patient Payment services will not only take the weight of these responsibilities off of your staff’s shoulders, but we will also save you time and money in the process. We will streamline the entire RCM process and keep the bills rolling out so the income can keep rolling in. We also offer call center services to handle all billing calls and have the skills and connections to maximize the rate of return for bills that are sent to collections.

Contact us at TRIARQ Health to find out more about how we can help you succeed in the highly competitive world of independent medical practices.