It comes at no surprise that getting claims paid is the biggest revenue cycle challenge for healthcare providers, according to a poll from the Medical Group Management Association (MGMA).
On average, health care providers send 3.3 billing statements before receiving payment, according to the MGMA. And sadly, providers can only expect to collect 50–70% of a balance after a patient visit, according to the Trends in Healthcare Payments Annual Report, 2015.
And the likelihood of payment decreases as the claim spends more time in accounts receivable. Within the first 90 days in accounts receivable, the collectability of accounts is 90%. Once accounts reach 90 days overdue, the chance of collecting drops to 50%. At 180 days, the chance of collecting falls to 20%. Account balances that are over a year old have about a 0% chance of collection.
What can be done?
To prevent claims in patient accounts receivable from going to collections in the first place, you need to secure patient payments as soon as possible; preferably before or at the time of service using a cost estimation tool.
Rivet’s financial and revenue cycle operations platform has helped healthcare providers across the country effectively manage the financial demands of today’s challenging healthcare landscape - from handling compliant estimates, accelerating upfront payments, delivering price transparency, managing payer performance, and everything in between.
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