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Why I Don’t Want to Pay My Doctor: A Patient’s Perspective

A recent visit for an annual physical left me feeling angry, cheated, and worst of all, broke. After expecting a twenty-dollar co-pay, I was shocked to hear the administrator at the front desk utter, “And, today, you owe, $275.” My eyes grew big, almost popping out of my head, “Excuse me?” I questioned. “I’m sorry; you haven’t met your deductible yet” she explained with a smile. “I’ve seen worse,” she added. I was confused and overwhelmed by the various thoughts flooding my head. Wait a minute, I have great insurance, an awesome job, and set that money aside for a fun weekend trip to Charleston, not to give to you, I thought to myself. Of course I couldn’t tell her that, so (like a responsible adult), I reluctantly handed over my debit card, turned around, and waited to see my doctor. I felt slighted in some way. Why didn’t someone tell me this before I booked the appointment? Why isn’t my insurance paying for this? Do I really owe that?

Surprise Bills Are the Worst Kind. While $275 may not seem like a lot to some, it was a shock to me, and something I wasn’t prepared for. This is an all too familiar story and a large reason why medical practices need to increase patient engagement and communication amongst practitioners. It’s beneficial to set clear expectations in regards to the patient’s financial responsibility before the appointment is even scheduled. It’s vital for everyone involved – the insurance companies, the medical practice, and especially the patient to understand what is owed. Patients are consistently confused about what they owe. Last year, 42% of consumers said they were confused by the bills they received from their providers.

If I don’t understand it, do I still have to pay it? Who wants to pay a bill when they aren’t sure they “really” owe what is listed on that bill? A friend of mine who recently had a baby, shared that she received multiple bills from various doctors. Now, eight months later, the bills are still being altered, corrected, and worked out by her insurance company and the hospital. Meanwhile, she’s been sent to collections, and now has a healthy baby and an unhealthy financial situation. According to the Medical Billing Advocates of America, 8 out of 10 hospital bills contain mistakes.

I have to pay for my dinner, but not my doctor? Due to a change in FICO scoring, medical bills now weigh less on your credit score, thus patients have even less of an incentive to pay their doctors. Working for a medical billing software company has shown me how much patient debt some practices are writing off. Meanwhile, doctors are becoming banks that provide financing for patients that are trying to pay their medical bills. Sometimes it takes patients years to completely pay their doctors, while the patients who are unwilling to pay their medical bills, or just simply can’t, are written off as bad debt with little to no repercussions for lack of payment.

Give Me Options. I want to pay my bill, but I’d rather do it online. My phone bill, my rent, my car payment, and even my power bill get paid online. Just like choosing an affordable phone plan, residence, automobile, or setting up fixed utility payments, I should be able to do the same with my medical bills. I enjoy the convenience of setting up automatic payments on a schedule that I choose. Unless it’s a personalized greeting card, I absolutely hate getting mail, where most of it ends up in either the trash or the shredder. I’m not alone! 93 percent of consumers would pay online through their provider’s or a health plan website. Providers need to understand, as a patient, we need multiple payment options and most of us, would rather pay you online.

The Struggle is Real. Even with insurance, many patients are struggling to pay medical bills. The Kaiser Family Foundation reported that one-third of Americans struggle to pay their medical bills. With increases in high deductible plans, the rising costs of prescription drugs (nearly 123.7% from 2000 to 2013), and stagnating income, it’s no wonder I’m more likely to go into bankruptcy from my medical bills than by supporting my shoe fetish. High deductible plans aren’t going away. If you don’t currently have payment plan options for your patients, you need to. There are many great options available to help patients pay their medical bills. Practices need to start offering these options to their most difficult payers; their patients. Just be sure to vet out these programs to ensure they have your patient in mind, and won’t hit them hard with high interest fees if they default on payments. Imagine recently launched ImagineHonorCare®, a flexible, interest free patient payment plan option. As a patient, and someone who works closely with providers and medical practices, this is a wake up call for providers to start offering patients more payment options, continue increasing patient engagement, and provide patients with the most accurate explanation of what they owe.

Now, let it be clear that I’m not saying it's acceptable to not pay your doctor. My goal is to provide a unique insider’s perspective from both a patient who has experienced frustrations and confusion surrounding medical bills, and as a professional, whose daily job is helping providers and medical practices with patient collections.

To find out more about offering patients a better way to pay, schedule a demo of ImagineHonorCare®, or contact:

Joya DiCristo
This email address is being protected from spambots. You need JavaScript enabled to view it.
704.887.1475

Resources: 

Instamed; Trends in Healthcare Payments Fifth Annual Report 2014: https://www.instamed.com/wp-content/uploads/Trends-in-Healthcare-Payments-Annual-Report-2014.pdf

Medical Billing Advocates of America; Why you Need a Hospital Bill Review: http://billadvocates.com/resources/need-hospital-bill-review/

FICO; FICO Score 9 Introduces Refined Analysis of Medical Collections: http://www.fico.com/en/newsroom/fico-score-9-introduces-refined-analysis-of-medical-collections

Kaiser Family Foundation; Medical Debt Among People with Health Insurance: https://kaiserfamilyfoundation.files.wordpress.com/2014/01/8537-medical-debt-among-people-with-health-insurance.pdf

Beckers Hospital CFOl; 50 things to know about healthcare costs: http://www.beckershospitalreview.com/finance/50-things-to-know-about-healthcare-costs.html

American Journal of Medicine; Medical Bankruptcy in the United States: http://www.amjmed.com/article/S0002-9343(09)00404-5/abstract

HonorCare®; Honor Your Health Payment Plan; http://www.imagineteam.com/healthcare/software/patient-pay-system

Top Class Actions; GE Capital Retail Bank Ordered to Pay $34.1M in Care Credit Refunds: http://topclassactions.com/lawsuit-settlements/lawsuit-news/31584-ge-capital-retail-bank-ordered-pay-34-1m-carecredit-refunds/

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Selecting a Medical Practice Management System

Imagine Software Helping Manage Medical Billing PracticesSwitching practice management systems can be an extremely difficult decision. Choosing which medical software to implement, learning a variety of new medical billing processes, and trying to make everyone happy about the change are just a few of the challenges organizations can encounter. More often than not, an upgrade in technology will pay off in the long run, but getting through the process itself can be, well, a process. Here are some helpful steps to get you started when searching for a new medical practice management system -

1. Establish a team who can assess your medical practice needs

2. Evaluate the entire patient and claims revenue cycle

3. Determine essential software features and functionality

4. Identify software vendors to consider

5. Request a formal proposal and schedule system demonstrations

 







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ImagineSoftware Wins New Contracts

For Immediate Release: Tuesday, October 9, 2012

Charlotte, NC - ImagineSoftware, a leading provider of medical billing solutions, announces the successful gain of five new clients over the past two months.

Each client will be implementing Imagineradiology™ at their respective locations in Florida, Georgia, Indiana, and Washington. Developed exclusively by Imagine, the complete practice management software solution incorporates billing, collections and reporting to increase cash flow, improve operational performance and increase practice profitability in the most cost effective manner.

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ImagineSoftware Unveils Imagine EFX for Global Billing Performance

Charlotte, NC - ImagineSoftware, a leading provider of medical billing solutions, announces the first look of Imagine EFX, the next version and 11th generation of its practice management suite.

Developed on a completely interoperable framework, Imagine EFX allows the system to be expanded on its secure, privacy-centric and ubiquitous platform.  EFX methods include browser-based, virtualized, native app, and enterprise presentation.  All methods are designed for simultaneous, multi-user, multi-mode environments and performance, providing optimal experience and efficiency to Imagine users from a variety of locations in real-time, all with advanced quality, speed, and security.

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Imagine Practice Management Software

ImagineSoftware's Practice Management Software improves practice cash flow, streamlines the billing processes and provides real-time practice KPI's. Our advanced billing software leverages your staff capabilities for a true “new generation billing" effort. Designed to further enhance the advantages of ImagineRadiology®Imagine's Practice Manager meets the needs of medical practices and billing companies by improving practical applications within the billing / collections system, including easy to use GUI, grouping of like-information and class together, automatic adjustment of screen size and resolution, and recent account retrieval of patient and practice information.

ImagineMedical Practice Manager is the industry's first intelligent multi-platform channeling practice management system. The core module of IMAGINEradiology®, Practice Manager, offers integrated radioloy billing features including: automated denials, radiology workflow, medical billing charge central, HIPAA audit trails, document management & archiving, denial mitigation, flex reporting and more.
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Big Data, Big Deal or Big Dread? And How Does It Impact Medical Billing?

What is Big Data, and how does it impact Medical Billing?

Big Data is on a lot of people’s minds lately, including those of medical billing administrators. Social media news feeds are filled with stories that promise everything from a cure to cancer, to the downfall of personal privacy as we know it. So what is Big Data, and how does it have any application to the world of medical billing? This is a question that many practice administrators are looking to answer. This post will explore the impact of Big Data reporting, and offer a few considerations to keep in mind while selecting a reporting solution to purchase.

Wikipedia has a well-written article on what Big Data is, and defines it as, “an all-encompassing term for any collection of data sets so large or complex that it becomes difficult to process using traditional data processing applications.”

Questions to Consider:
• Have you ever wanted to see what the true impact of CMS (Centers for Medicare and Medicaid Services) combining services has on your business?
• Have you ever tried to setup reports that show a comparison of insurance adjustments to uncover factors that are involved in the changes you see happening in your payer mix?
• Are you interested in showing the Relative Value Unit for how much work your doctors have performed, relative to the reimbursement amount they are receiving for their services?

If you have ever wanted to know the answer to these questions, or similar questions, then Big Data collection and analysis applies to your medical billing practice. With most billing systems a user can only use a small amount of the data to establish trends for these kinds of questions. Depending on the daily volume of posted charges, sometimes you can access as little as 5 months worth of transactional data before reaching the limit for the amount of data that can be shown in a report. This limitation is not always the fault of the software, and typically resides with the computer hardware not being able to process the required amount of information. Trying to establish trends while working around these limitations can become nearly impossible for some practice managers, due to the sheer volume of data they have to organize. Big Data is not a theoretical concept that may one day start to impact the medical billing office, it is an everyday reality for any practice manager who posts more than half a million procedures a year. This massive amount of data illustrates what the IT industry is referring to as Big Data.

The good news is that while the amount of data being pulled to do business analysis has changed, the concepts of what needs to be analyzed is still the same. The need to report on trends for metrics and key performance indicators has not changed. What has changed is the increase of complicated business research required to help managers and administrators set benchmarks and forecast trends. It now includes a more sophisticated method for processing data. Big Data has created a need to not just store massive amounts of information; it has also forced software developers to come up with innovative ways to make that information accessible for analysis. So what kinds of reporting tools do you need to accomplish this? You will need advanced tools that offer everything from early warning alerts and user productivity dashboards, to secure web accessible items that allow any member of your organization to remotely monitor your business. Most advanced reporting tools fall in to the Business Intelligence software category, due to their capability of monitoring live data trends without the user being required to open the application.

Before you look into a new reporting tool, here are a few things you may want to keep in mind:

Separate what you Need from what you Want:
It would be nice for every team member to access all of the metrics for their responsible areas from their smart phone, any time they are away from the office, but do you need this ability? Most reporting tools charge a per user access license fee, and most price their licensees based on the kinds of features and access each user will have when working with the product. Make sure that you are planning ahead for future licensing needs as well as purchasing features that are relevant to your business model and that your team prioritizes needs over wants before negotiating a contract.

Nothing powerful comes for free:
Time to talk about system performance cost. If your system has a massive amount of data to process before it can be extracted for a reporting tool to access, then a server somewhere on your network is going to need to dedicate resources to make that happen. Virtual servers usually are very bad at this kind of processing but cost less money to get off the ground. If you do not have the ability to create a new server, what will the performance impact be on the existing server(s) that will host the reporting processes? Make sure your IT team is part of the discussion with your vendor to ensure that running a report will not bring your billing system to a halt while the report is running.

The more powerful the product the higher the learning curve
One of the biggest obstacles that Practice Administrators will be facing as they look into obtaining a reporting tool will be determining who on their team needs to be trained to use it. Some organizations have a heavy enough volume of analysis needs that they have a full time employee who does nothing but run advanced reports. Others do not have this resource available. It is important to realistically evaluate whether or not your team members tasked with running advanced reports have more than a passing knowledge of Excel. At the same time, your reporting product needs to be intuitive enough that these individuals can learn it without earning a business degree in the process. Make sure that you collect plenty of user experience feedback on potential reporting solutions to see how long it took users to get up and running.

The most meaningful data comes from focused analysis
Any reporting tool you use to help dig through your data is going to provide you with a number of ways to categorize and sort that data into meaningful categories and relationships. The only way to maintain your sanity in this kind of situation is to stay focused. Before purchasing a tool, have a set of specific reporting needs that you want to accomplish with it. Keep the list small, no more than five, ensuring your most important reporting needs are being directly addressed. Many Billing Software Vendors have advanced reporting tools that have a number of prefabricated reports that may or may not meet your needs. Ask them to demonstrate how to meet your list of needs in their tool to make sure that you are getting what you need, not just what you are being offered.

Keeping these items in mind while approaching a new reporting tool will help set expectations when evaluating products, and guide you towards a tool that will provide you with meaningful data. By considering these factors, you will be able to reach your operational goals as opposed to choosing a tool that is so complex your team does not embrace it.

Will Big Data mean anything for the day-to-day life of front line workers? Yes, but in indirect ways. The real impact will be felt by managers and team leaders who oversee daily operations, who now have real data on how their team is contributing to meeting organizational goals. Advanced reporting tools will not just monitor employee progress, but will also identify breakdowns in processes and highlight areas where the team needs more resources, in order to meet their goals. These tools will also give new insight into shifts in revenue and services your doctors are preforming. If your organization has a clear direction and focus on where it wants to go, business intelligence reporting tools like our company’s ImagineIntelligence module, will not only validate the reality of those goals, but will help you stay on target to accomplish them. That only becomes possible if you have the ability to leverage your Big Data in a meaningful way. Big Data ultimately means more information to base decisions on. Make sure that you are taking full advantage of your data today.





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  • Medical Practice Management System
    Medical Practice Management System

     

    Medical Practice Management System

    ImagineBilling™ Practice Management Software improves cash flow, simplifies processes and provides unprecedented, real-time productivity monitoring by streamlining the billing/collections workflow to help clients achieve peak performance and measurable results.

     

    Meeting the needs of hospitals, medical practices, and billing companies across the country, the Imagine system enhances everyday applications within the billing process, reducing the lifecycle of claims to increase practice profitability. Easy-to-use navigation, grouping of like information and class together, automatic adjustment of screen size and resolution, and recent account retrieval all work to leverage staff capabilities for building efficiency and adding value while applying high quality standards to data integrity.

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    MedFM

    Boost Productivity
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    ImagineMedFM™ is a comprehensive medical management software solution for medical billing and practice management services. MedFM delivers unsurpassed flexibility and user productivity in a dependable, user-friendly system.

    Flexible Deployment Options Based on Your Management Needs

    MedFM has the dual ability to be used as an in-house solution or can be available on-demand at a low monthly subscription fee – hosted in the cloud – allowing you flexibility in the management of your practice.