ProviderS
When physicians file a claim with a third-party payer, the process is usually smooth, and payment prompt. By contrast, collecting from individual patients is complicated, paper intense, inaccurate, time-consuming, and often unsuccessful.
Uncollected co-pays, deductibles, coinsurance and other amounts billed to patients after they have left their physician’s office account for 75% to 85% of the total amounts due from patients with insurance—and payment is hardly guaranteed. Our data suggest that patient-pay non-payment rates are greater than 60%.
In a January 2005 article published by McKinsey & Company, authors Mango and Riefberg state that for some provider groups "unpaid consumer bills already equate to 10% or more of net revenue." For a physician practice, losses of that magnitude would easily exceed $10,000 per physician per year. Still, practice costs will rise as a result of more billing, more follow up, and more collections activity. And while the costs of patient billing and collections grow, the costs of billing operations will often remain unchanged because the design still requires a claim for every patient encounter.
Patients do not fare well either. They blame both providers and health plans for the delays and confusion. Over time they have learned to treat healthcare bills differently from other service-related bills. At the time of service, they don’t know the total cost or the amount they will be required to pay. Weeks or months later they may receive bills marked "informational" or, "this is not a bill," which add to their confusion. In the mix will be more mailings from their health plan, often full of confusing codes and messages. Patients often decide to wait for a few more cycles to see if they can discover the final amount due. Sometimes they receive calls from collection agencies – and threats to their credit rating – before they know what they owe or even realize they have received a "final" bill. So, the problem compounds, and a culture of non-payment continues to grow.
MedDirect’s PPS program is the solution to the non-payment/slow-payment problem.