(6 min read) Today, healthcare providers are under increased pressure to ensure a positive patient journey - one that prioritizes the billing experience as part of the total care experience. Patients are more likely to pay their bills when they understand their explanation of benefits (EOB) statements and believe the information is correct.
How can EMS agencies meet both patient and provider demands for accuracy, efficiency, and transparency? Billing technology is now available to automate workflows so that claims are routed properly, billing lag is minimized, and patients receive accurate bills in a timely manner.
EMS Technology Improves Billing and Patient Experience
Traditional pre-billing, claims processing, and compliant coding are labor-intensive processes that affect the ability to ensure efficient, accurate billing. When billers are not able to obtain and verify patient demographics and insurance coverage during or after a medical emergency, patients often receive incorrect EMS bills, or their statements are sent to the wrong address and delayed in the mail. The patient might have received excellent care and transport from your team, but if billing errors result in an inaccurate or delayed bill in their mailbox, that event detracts from their overall perception of the experience.
Patients don’t want to spend time contacting insurers or providers to resolve claims issues. They simply want the system to work. That means expecting a statement that accurately captures insurance coverage and patient financial responsibility. Agencies can deliver on patient expectations by leveraging advanced technology to boost billing performance - promoting patient satisfaction while improving operational efficiencies and claims processing time.
More than ever before, patients are becoming informed healthcare consumers, especially when their financial stake continues to grow. As patients engage in managing their cost of care, they need a clear understanding of what they owe for services. Account-based billing provides one consolidated bill versus multiple statements for a single event. In addition, patient bills are customized to accept various payment options. And for patients facing financial hardship, Adaptive Financial Assistance (AFA) provides individualized patient engagement plans with customized finance terms to accommodate individual circumstances.
Billing technology can automate manual processes so that accurate claims are submitted quickly and patients receive a single statement for all charges. This capability is also a benefit for billers, as it reduces the number of statements printed and mailed, eliminating complexity while saving time and postage costs.
By eliminating billing errors, more claims can be processed with fewer resources to deliver more revenue and improve patient satisfaction. To that end, billers processing claims rely on capabilities offered by best-in-class technology:
- Demographic Verification - Obtain complete and correct patient information for every claim, every time
- Insurance Discovery - Identify primary, secondary, and tertiary insurance coverage for patients
- Insurance Verification - Run patient eligibility to verify that the patient has active coverage on the claim’s date of service
- Self-Pay Analysis - Determine which of your patients can pay and discover those who qualify for charitable coverage or a hardship discount
Streamlining the claims process provides visibility into monthly revenue and helps to achieve optimal billing performance.
Ensuring Privacy and Security Compliance
Protecting patient health information is a top priority. Cloud-based billing solutions carry all the advantages of a secure platform to address personally identifiable information (PII) privacy concerns and ensure HIPAA compliance.
- Data is automatically updated and backed up in real time
- Security is maintained at the highest levels, and security updates are automatically installed
- Cyber threats are prevented and/or detected at the earliest opportunity
- Software is upgraded on an ongoing basis
With cloud-based solutions, there’s no need to invest in dedicated on-staff IT experts or to hire costly consultants. Administration, maintenance, and infrastructure are all handled in the background. Billers enjoy all the convenience of the cloud: the software and data are available anytime, from anywhere.
High-Deductible Health Plans Create Challenges
As the number of unemployed U.S. workers continues to climb in the midst of the pandemic, high-deductible health plans (HDHP) pose unprecedented challenges for patients and providers. According to a survey published in JAMA Internal Medicine, the risk of unpaid bills is steadily increasing with more than 40% of privately insured Americans enrolled in a high-deductible health plan.
The financial plight of EMS agencies is linked to the increase in the number of patients covered by HDHPs, since payment depends on the patient’s ability to meet a high deductible before insurance coverage kicks in. Fortunately, EMS billing technology can determine whether or not the patient’s deductible has been met. If not, agencies can hold a claim until the hospital has collected the patient deductible. Once that has been met, the payer is responsible for the patient’s bill.
Strategies to Support EMS Billing, Patient Satisfaction, and Optimal Revenue
When it comes to patient satisfaction with the financial experience, two priorities top the list: receiving one bill, one time, with the correct information; and maxing out their available insurance coverage. Best-in-class billing technology solutions can help EMS billers get everything right at the pre-billing stage to help make sure that patients reap all available benefits.
EMS providers should strive to improve patient satisfaction for many reasons. First, it’s an important quality measure for your agency. It’s a tangible data point against which you can measure progress toward goals. Second, agencies want to establish and maintain their good reputation in the community so that patients know they’re in good hands, should they require EMS services. Third, if your agency is publicly funded, high patient satisfaction is an important measure of value for investment.
Don’t let a positive care experience be overshadowed by a bad billing experience. Consider these five tips for leveraging billing technology to promote patient satisfaction:
- Make sure you have correct patient demographic information, and use demographic verification tools to increase accuracy and eliminate manual verification
- Submit accurate claims and bills with clearly presented information
- Determine propensity to pay and consider offering an individualized payment plan to improve the patient experience while increasing revenue
- Provide a single, consolidated statement that truly reflects patient responsibility
- Verify Medicare benefits or Medicaid eligibility