Medicare Compliance & Reimbursement - 2017 Issue 4
Reimbursement: Change Your Game Plan to Prepare for Increased Out-of-Pocket Pay
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Article Overview
This article explains how the growth of high-deductible health plans is affecting patient collections, revenue cycle performance, and practice profitability. It is geared toward billing staff, practice managers, and revenue cycle teams that need general guidance on eligibility verification, patient cost communication, and proactive collection workflows. The article covers broad reimbursement and front-office process changes, along with the importance of helping patients understand their financial responsibility before care is delivered.
Why This Topic Matters
As more payment responsibility shifts to patients, practices may face slower collections and more administrative burden unless they update their revenue cycle and front-desk processes. Understanding the operational impact of high-deductible coverage helps practices reduce avoidable payment problems and maintain cash flow.
Article Sections
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The High-Deductible Health Plan Challenge
Introduces the growth of high-deductible coverage and its effect on billing, collections, and days in accounts receivable. It frames the operational challenge for practices in a changing reimbursement environment.
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What is an HDHP?
Provides background on high-deductible health plans and summarizes broad plan features and market trends. It explains why these plans matter to patients, employers, and provider organizations.
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Be Proactive: No More “File-and-Forget”
Focuses on front-end billing and collection workflow changes that support better patient payment handling. It discusses verification, communication, and collection process improvements before and at the time of service.
What You Will Learn
- How high-deductible health plans are influencing patient responsibility and practice cash flow
- Why proactive eligibility and coverage verification matters more in a high-deductible environment
- How front-office communication can help set expectations about patient financial responsibility
- Why practices are emphasizing earlier collection workflows and payment planning
- How revenue cycle teams can adapt general billing processes to changing insurance trends
Who Should Read This
- Billing staff
- Revenue cycle managers
- Practice managers
- Front-office staff
- Health care administrators
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