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How Emergency Medicine Providers Can Mitigate Self-Pay Collection Challenges

ZOLL Data Systems | Apr 26, 2023

Across the country, emergency medicine providers are strapped by workforce gaps and swamped by a rising tide of patient visits to the emergency department (ED). The challenge to deliver quality care with fewer resources is adding significant operational and financial strain on emergency medicine providers. 

The industry’s challenges are compounded by the fact that the financial responsibility for healthcare is increasingly landing on the patient. The number of patients who are self-pay or covered by high-deductible health plans (HDHP) has ballooned in recent years, and with the end of the public health emergency (PHE) looming, the trend is expected to continue.

It’s no secret that self-pay and HDHP patients take longer to pay and have a higher risk of write-off. Healthcare expenses are often unaffordable for patients, and the costs can be steeper than expected because essential demographic and insurance information can be missed in the rushed environment of an ED. Collecting outstanding receivables slows dramatically with self-pay accounts, and the downstream effects are higher costs and lower profits for emergency medicine providers. 

Providers can effectively combat the intake and collections issues by leveraging the right automated healthcare data technology. Instead of relying on the patient, an automated AR (accounts receivable) optimization tool can find, correct, and verify patient and payer information. This real-time technology helps providers improve their clean claims rate and reduce days sales outstanding (DSO) with tools that include:

It may seem like a big ask for emergency medicine providers to invest in new technology in the current healthcare environment, but there is proven ROI for AR optimization tools: emergency department reimbursement can improve by an average of 29% after implementing automated insurance discovery, demographic verification, and deductible monitoring. Even using a scaled back version of the technology and investing in just a robust insurance discovery tool can make a significant, positive impact on DSO.

Today, it is more important than ever to use technology to better understand a patient’s eligibility and financial characteristics so that billers can submit clean claims and reduce the time to cash — improving patient experiences and financial performance.

To learn more about how to collect outstanding receivables faster, even when the payer is the patient, read our recent article in Becker’s Hospital Review.

Learn More About How To Improve Emergency Medicine Financial Performance:

How Emergency Medicine Physicians Can Increase Revenue With Medicare PFS Cuts Looming

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