Ark Health Solutions - Patient Calling (Inbound & Outbound Calls
Generate Patient Statements
Once the biller has received the report from the payer, it’s time to make the statement for the patient. The statement is the bill for the procedure or procedures the patient received from the provider. Once the payer has agreed to pay the provider for a portion of the services on the claim, the remaining amount is passed to the patient.
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In certain cases, a biller may include an Explanation of Benefits (EOB) with the statement. An EOB describes what benefits, and therefore what kind of coverage, a patient receives under their plan. EOBs can be useful in explaining to patients why certain procedures were covered while others were not.
Follow up on Patient Payments and Handle Collections
The final phase of the billing process is ensuring those bills get, well, paid. Billers are in charge of mailing out timely, accurate medical bills, and then following up with patients whose bills are delinquent. Once a bill is paid, that information is stored with the patient’s file.
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If the patient is delinquent in their payment, or if they do not pay the full amount, it is the responsibility of the biller to ensure that the provider is properly reimbursed for their services. This may involve contacting the patient directly, sending follow-up bills, or, in worst-case scenarios, enlisting a collection agency.
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Each provider has it’s own set of guidelines and timelines when it comes to bill payment, notifications, and collections, so you’ll have to refer to the provider’s billing standards before engaging in these activities.
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Patient Payments
As soon as remittance advice is posted, patient statements should be sent for all outstanding balances. The sooner the statement is received by the patient, the sooner it will be paid. Patient statements should detail the date of service, services performed, insurance reimbursement received, payments collected at the time of service, and reason the patient balance is due.
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Once these final payments are made by patients, commonly arriving by mail, they should be posted and balanced. With many patient cases, this completes the billing process and closes the patient account.