“Patient Healthcare Costs Rise Again, ClinicSpectrum’s Solutions Lessen the Burdens and Increase Revenue” According to a recent article dated November 13th, 2014 on Forbes.com, “Worker Out-Of-Pocket Health Costs Have Doubled In Five Years”, the healthcare landscape is predicted to change even further in 2015. “As the economy improves and employees spend more on health care, employer-paid premiums are rising again with an increase of 5.5 percent forecast for 2015 with worker premiums and out-of-pocket costs – which have doubled since 2009 – rising at an even faster clip.” Additionally, the annual healthcare costs per employee have risen from $10,717 to $11,304 this year. This means that more out of pocket expenses are outstanding and collecting that money can raise new challenges for medical groups. Strategic solutions must be implemented in the areas of proper benefit verification, and automated patient collections to reduce revenue downfalls for practices. In fact, practices are generating up to 30 to 40 percent of their revenue from patients who have high-deductible insurance coverage. Failing to check patient eligibility and deductibles can increase denials, negatively impact cash flow and profitability. One solution is to improve eligibility checking using the following best practices: -Check patient eligibility 48 to 72 hours in advance of scheduled visit using one of these three methods: 1. Business-to-business (B2B) verification, which enables practices to electronically check patient eligibility using electronic data interchange (EDI) via their electronic health record (EHR) and practice management solutions. 2. Look up patient eligibility on payer websites. 3. Call payers to determine eligibility for more complex scenarios, such as coverage of particular procedures and services, determining calendar year maximum coverage, or if services are covered if they take place in an office or diagnostic center. Clearinghouses do not provide these details, so calling the payer is necessary for these scenarios. -Determine patient financial responsibilities – high deductibles, out-of-pocket limits, then counsel patients about their financial responsibilities before service delivery, educating them on how much they’ll need to pay and when. -Determine co-pays and collect before service delivery. Another area of potential pitfall for revenue optimization comes from collecting patient balances after the services have been rendered. It is imperative for medical groups to turn to automated solutions to help recover those balances seamlessly and effectively. Automated collection software can be installed and managed by practices to relentlessly – within regulations – contact debtors to increase collection rates. Traditional collection methods of standard mail delivery and costly representative phone calls are replaced by a more elaborate, seamless, cost-effective auto collection process. Automated c

1. “Patient Healthcare Costs Rise Again,
Clinicspectrum’s Solutions Lessen the Burdens and
Increase Revenue”
New Jersey
2222 Morris Ave. 2nd Floor,
Union, NJ-07083
Phone : 908-834-1608
Fax : 877-600-9390
Sales
Ph: (908)-834-1608
Email: info@Clinicspectrum.com

2. Article on Forbes.com 02
According to a recent article dated November 13th,
2014 on Forbes.com, “Worker Out-Of-Pocket
Health Costs Have Doubled In Five Years”, the
healthcare landscape is predicted to change even
further in 2015. “As the economy improves and
employees spend more on health care, employer-paid
premiums are rising again with an increase of 5.5
percent forecast for 2015 with worker premiums and
out-of-pocket costs – which have doubled since 2009
– rising at an even faster clip.”

3. Annual Healthcare Costs per Employee 0013
2013
2014
$11,304
$10,717
This means that more out of pocket expenses
are outstanding and collecting that money can
raise new challenges for medical groups.
Strategic solutions must be implemented in
the areas of proper benefit verification, and
automated patient collections to reduce
revenue downfalls for practices.
Practices are generating up to 30 to 40
percent of their revenue from patients who
have high-deductible insurance coverage.
Failing to check patient eligibility and
deductibles can increase denials, negatively
impact cash flow and profitability.

4. Solutions to improve Eligibility Checking 0014
Check patient eligibility 48 to 72 hours in advance of scheduled visit using one of these three methods:
Business-to-business (B2B) verification, which enables practices
to electronically check patient eligibility using electronic data
interchange (EDI) via their electronic health record (EHR) and
practice management solutions.
B2B Verification
Look up patient eligibility on payer websites. Payer Website

5. Solutions to improve Eligibility Checking 0015
Determine co-pays and collect before service delivery.
Determine patient financial responsibilities – high deductibles, out-of-pocket
limits, then counsel patients about their financial responsibilities before
service delivery, educating them on how much they’ll need to pay and when.
Call Payers
Call payers to determine eligibility for more complex scenarios, such as
coverage of particular procedures and services, determining calendar year
maximum coverage, or if services are covered if they take place in an office
or diagnostic center. Clearinghouses do not provide these details, so calling
the payer is necessary for these scenarios.
Determine Co-Pays
Counsel Patients

6. Revenue Optimization 0016
Another area of potential pitfall for revenue optimization comes from collecting patient balances after
Patient
the services have been rendered
Automated Collection Software
Automated collection methods using
technology platforms, decisions rules and
messaging such as text, email, push
notifications on smart phones and automated
calls to allow seamless, consistent results for
balance collection.

7. Can be installed and managed by practices
to contact debtors to increase collection rates!
Traditional collection methods of standard
mail delivery and costly representative phone
calls are replaced by a more elaborate,
seamless, cost-effective auto collection process.
0017

8. Follow Us on Social Media 0018
https://twitter.com/clinicspectrum https://www.facebook.com/ClinicSpectrum
New Jersey
2222 Morris Ave. 2nd Floor,
Union, NJ-07083
Phone : 908-834-1608
Fax : 877-600-9390
Sales
Ph: (908)-834-1608
Email:
info@Clinicspectrum.com