One of the main risks associated with running a medical practice is the ability to convert revenue into positive cash flow. Revenue languishing in A/R is a growing concern in the healthcare industry. Larger out-of-pocket liabilities lead to bad debt for consumers and lower revenues and yields for providers, who must renegotiate contracted network discounts with health plans to remain profitable. Payers then increase premiums charged to employers and individuals, completing and continuing the cycle. Expenses encountered through debt collection also eat away at bottom line profits.
The emerging model addresses key phases of the revenue cycle: three points of service — pre-service financial clearance, point of service interaction and post-service settlement —and a fourth phase, performance analysis. Providers must take a proactive approach to securing payment bycollecting from patients at all points of service.