Consumerism and your practice’s cash flow

Consumer-directed health plans are an emerging solution for the problem of growing health care costs. Usually combining a higher than average deductible and a Health Reimbursement Account (HRA) or Health Savings Account (HSA), these plans are designed to increase the financial responsibility of the patient as well as their involvement in health care decisions.

So with patients shouldering more of their own health care costs, does that place your practice’s accounts receivable in jeopardy? Not necessarily.

As health plan trends change, so must practice processes. Technology allowing for real-time eligibility checks, claim editing and tracking as well as payment and collection modifications helps patients make informed decisions and assist practices with collecting payments in a timely manner.

Eligibility verification
Sage Software offers a fully integrated system that allows you to automatically view current eligibility as soon as the patient record is opened.* The Automated Eligibility Verification system automatically checks batches of scheduled patients’ eligibility prior to their appointment without requiring any extra time from the staff.

When patients arrive, the information is presented in seconds as staff members retrieve the patient record, so that financial counseling discussions can occur before the patient is seen. For walk-in patients, real-time eligibility verification is also available. Additionally, staff can access the exact same eligibility information again when responding to queries from patients and payers.

Claim Accuracy and Visibility
Utilizing a claim scrubber or editor can help a practice isolate coding errors prior to submission, and can go a long way toward reducing days in A/R.

Intergy by Sage provides an integrated Claim Tracker that lets you query the payer system to check status, quickly identify denials, and initiate resolutions much faster than ever before. To help you track and amend denied claims, Intergy allows you to create workflow-based tasks that are automatically routed to the appropriate individual for follow up.

This allows your practice to prioritize tasks, so no claims are lost and billing problems are addressed in a timely manner. They can also be tracked by managers.

Payments and collections
With Electronic Remittance Advice (ERA) from Sage Software, your practice can electronically post payments directly into a patient’s account complete with write downs, proper payment allocations and responsibility transfers. You can also post remittance advice for Medicare intermediaries, many major commercial payers and BC/BS plans. Extensive reporting features allow practices to view detailed Remittance Advice Reports and Summary Claim/Payment Reports that print charges and payment summaries for each batch.

Sage Software’s Electronic Statement Remits provide your practice with an electronic payment processing solution that eliminates manual posting tasks and helps ensure the accuracy of payment posting while improving your revenue stream. Patient payments can be mailed directly to the practice’s Sage Software lockbox service, where payments are scanned, deposited and the balance due is verified. Practices can retrieve payment detail electronically on a daily or weekly basis.

Intergy includes a collections system that helps practices improve cash receipts by managing delinquent accounts receivable owed by guarantors and insurance plans. The collections module allows your practice to fully optimize the time spent in each work session. By automatically isolating which accounts need attention, the system is particularly useful when only a limited time is available for collections.

Ready to get started?
Intergy’s enhanced cross-functional features promote proactive task management to help you increase revenue, decrease denials and enhance your practice’s ability to provide high quality patient care. And the EDI features mentioned are available to Sage Software customers through the Network Services product offering. Find out more about how these tools can benefit your practice by:

* The data received from individual payers may vary, and not all insurance payers have electronic eligibility capabilities.