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Telemedicine – Fad or Future?

In 1968, a book called Five Patients introduced America to telemedicine.  At that time, it seemed more like science fiction than reality.  The book was written by Michael Crichton, who would later become famous for a better known book, Jurassic Park.  Skip ahead to 2015, the Mordor Intelligence report predicted that the telemedicine market will grow to be greater than $34 billion by the end of this decade.  And in February of this year, the Mordor Report was updated and now predicts that the telemedicine market growth will reach $66 billion by 2021.

As the cost of healthcare continues to rise, deductibles continue to increase and companies drop health benefits altogether, telemedicine offers an appealing alternative to traditional healthcare settings.  Telemedicine works well for the elderly, those in care for chronic disease, time bound individuals and the less mobile or rural populations.

Advocates of telemedicine cite several benefits.  Not the least of which is convenience. Patients could access their provider virtually on demand.  It is anticipated that hospital admissions and readmissions will be decreased because of improved patient compliance and ongoing monitoring.  Patients who live in rural areas will have greater access to care and those who are time-bound would be more inclined to set a telemedicine visit then to try and schedule a traditional visit.

The Challenges

Despite the positive aspects, there are factors that stand in the way of immediate growth.  One of the challenges is that many providers 55 or older are more comfortable practicing medicine in traditional settings.  The older they get the less likely they are to want to make changes in how they practice medicine.  And then there are reimbursement and legal issues.  Currently, telemedicine laws for reimbursement are handled state-by-state.  Inconsistencies in reimbursement and legal definitions of what constitutes care are continually addressed by organization like the American Telehealth Association.

It is not unreasonable to assume that such hurdles will be overcome and that telemedicine will indeed grow.  Many have embraced technology and more will demand such access.  More and more physicians will adopt telemedicine in their practices to bring convenient, low-cost, high-quality care to their patients.  Undoubtedly, future physicians and providers will see telemedicine as simply another tool to serve and care for their patients.

For state-by-state information visit the ATA State Policy Resource Center.

Patient Deductibles Can Strangle Your Cash Flow

5 Tips to Normalize your Cash Flow

At the beginning of each year, many physician practices face shortfalls in cash flow due to health plan deductibles.  Medical deductibles can play havoc with physician practices.  Health plans have consistently increased deductibles and, of course, the Affordable Care Act (ACA) plans are now in the mix.  Thus, a greater financial burden is placed on the patients for medical services and, in turn, physician practices are left to deal with the cash flow slow down.

Not so very long ago, a large portion of the medical bill was traditionally paid by commercial insurers, Medicare and other third-party payers.  But now, the landscape has changed.  Physician practices are forced to walk a fine line between providing good clinical care and limiting the burden associated with increased costs.  There are no other professions where consumers expect to receive services or goods and pay later.  But that is exactly what happens with health care.

At the beginning of each year, patients must first meet their deductibles before reimbursements will be sent to the provider.  So when you submit your bill the majority, if not all, of the allowable (what the insurance carrier would usually pay directly to you) is applied to the patient’s deductible.  Therefore, you get $0 from the insurance carrier and you must then bill the patient and wait for payment.  This can result in a delay of payment for 45-90 days.  Without excellent collection efforts from your billing team it can even result in bad debt.

What does this mean for your practice?

Let’s say Dr. Brown’s monthly collections average $100,000.00 and the total patient deductible amount for the month is $25,000.  If Dr. Brown did not collect any money from the patients at the time of service, then the projected collections for the month would be his average of $100,000 – $25,000 in patient deductibles = $75,000.  Rather than his average of $100,000 he would have only $75,000  to pay his expenses.

Ultimately, patient balances should be collected.  But how long can your practice wait for this money?  How long can you provide these interest free loans to your patients?  Below, are five practice tips to keep patient deductibles from strangling your practice.

  1. Staff members need to know what a plan covers;
  2. Verify eligibility and deductible status before every visit;
  3. Have honest conversations with patients and explain patient responsibility up-front;
  4. Collect whole or partial payments from the patient while they are in the office;
  5. Develop payment plans.

The best way to minimize the impact of deductibles is to be proactive with patients by detailing costs and  requiring a payment of the patients’ deductible.  At first, this may seem awkward or you may feel uncomfortable asking for a payment upfront, but in today’s health care environment more assertive tactics are needed to protect your bottom line.