In the post-Obamacare landscape, healthcare practices are experiencing a major shift in payment velocity—the time between a patient visit and the final cash-in-hand. While the Affordable Care Act (ACA) has made health insurance available to millions more Americans, many choose lowest-cost “bare bones” options which ultimately require higher deductibles, copays and other patient-borne costs. In extreme cases, families are actually “on the hook” for an out-of-pocket maximum as high as $7,000 before insurance finally kicks in.
For many new patients—particularly younger patients new to the healthcare system or those who haven’t had the opportunity to see a doctor for a while—the first bill after a doctor’s visit often brings a profound case of “sticker shock” as yesterday’s low premiums lead to higher deductibles today. To paraphrase the slogan from a famous old motor oil commercial, underinsured patients can either “pay now…or pay later”.
For practices, what was once a reliable stream of steady compensation from insurance payers now means collecting as much as 25 percent of revenue directly from patients. When a patient is overwhelmed by an unexpectedly high bill, the whole collection process can become bogged down or bottlenecked.
How can practices prevent patient sticker shock to maintain a steady cash flow–with minimal defaults? The best answer may be to present patients with an accurate pay estimate at the time of care. This is an added advantage of Infinx’s advanced workflow management solution: iBridge.
When a new appointment is scheduled in the provider’s front office system, patient data is automatically converted into an HL7 message sent to iBridge for processing and coordination with the patient’s payer.
iBridge next compares the patient’s allowed amount against copay, deductible and other costs, presenting an accurate, real-time breakdown of the patient’s out-of-pocket responsibility. The patient then understands their financial obligation before they leave the office, reducing the possibility of financial hardship or default.
While the idea of providing front-end patient pay estimates may not be new, iBridge streamlines the process with higher speed and accuracy. Providers can present viable treatment options within the patient’s financial “comfort zone,” while the patient can realistically predict payments before an unpleasant surprise hits their mailbox.
To learn more about iBridge and other Infinx advanced RCM solutions for your practice, click here.