AAHAM_The Three Phases of Revenue Cycle Staff Training(0315)

INTEGRITY | TEAMWORK | COMMITMENT | RESPECT | EXCELLENCE

Chuck Seviour, VP – Revenue Cycle Consulting

Three Phases of Modern Day Revenue Cycle Staff Training

• More people than ever before are purchasing health insurance.

• More people than ever are required to pay medical bills

• Employees cutting healthcare costs by offering employees insurance plans with larger out-of-pocket costs

• Providers now serving patients with higher financial responsibility

What has happened under Patient Protection and Affordable Care Act.

Most Affordable Care Act enrollees were previously uninsuredInsurance status of ACA exchange enrollees when shopping for health coverage:

SOURCE: Kaiser Family Foundation

UninsuredHad Employ er

CoverageHad Individual

CoverageHad Medicaid/other

Public Program

57%

18% 19%

9%

Average General Annual Deductible Among Covered Workers Enrolled in a Plan with a Deductible for Single Coverage, by Firm Size, 2006-2014

• Patients receiving healthcare need to be educated on their self-pay responsibilities

• Patient Education begins in the hospital the minute a patient is coming in for a service and when the patient becomes a patient in the ED

• Patient education for the clinic begins when the patient calls to schedule an appointment

Effective and timely communication is essential

• Patient does not understand why they need to pay so much when they have insurance

• Patient does not understand deductibles and co-pays• Patient confused when they get the bill• Patient does not become a “satisfied patient”• Facility Patient surveys become impacted dramatically

The Impact of Doing Nothing!

Average monthly premium costs before and after the Affordable Care Act

• Education of your Patient Access and Registration staff• Education of your Employees and Management at all levels• Appropriate tools for Prior Authorization• Ability for estimating charges both insurance and self-pay

Today’s Essential Approach to Self Pay Management

• What are you doing today and what should you be doing?

• What changes are taking place to increase patient satisfaction surveys often hurt by patient concerns regarding billing

• How would an educated patient change the dynamics of collecting self-pay today

65%A Chuck-ism: At least 65% of

Patients want to know the out-of-pocket costs, prior to service,

particularly in the hospitals

Questions?Thank You