We all know that healthcare industry continues to mark high patient financial responsibility and out-of-pocket costs. Healthcare professionals ensure that medical billing services help the pay process to yield high patient satisfaction. A positive experience with the medical billing services can obviously influence the patient’s billing. This is not to portray patients withhold their payments as a punitive measure following a complex or negative billing department experience. It shows that providers should make the patient payment process simpler.

Making patients understand their financial responsibility, making them aware of potential charges before they receive their bills, and giving them a compassionate and empathic experience will be essential to create a patient-centered experience.  Here are few frequently asked questions on patient’s medical billing services.

Do Medical billing services companies offer payment arrangements?

  • Of course, payment arrangements may be made by contacting medical billing partner’s patient billing customer service.

What are the Patient’s payment options?

  • Most of the medical billing service companies offer all forms of standardized payment options that are accepted, including cash, check, and major credit cards.
  • To pay by credit card over the phone, please call customer service.
  • Patients may also pay in cash at the hospital or mail their payments to the payment address listed on the patient statement.
  • Text-to-pay is another available option which is easy to deal with.

Why do patients receive separate bills from the hospital and from the physician?

  • When a healthcare professional performs the services, patients are required to submit their bill separately from the hospital’s bill.
  • For example, if patients came to the emergency room and had an x-ray and laboratory tests, they may receive a bill from the hospital for technical resources, a bill from the emergency room physician for professional services, a bill from the radiologist for interpreting any x-rays, and a bill from the pathologist for analyzing any specimens taken.

Patients find the same bill listed on healthcare professional’s bill and hospital’s bill. Why?

  • Each and every hospital visit involves both physician and hospital bill for the resources utilized while performing services.
  • Although the hospital and the healthcare provider may use the same language to describe each charge, their bills are for separate services. The physician’s bill will be for professional assessment, direction and oversight.
  • The hospital’s bill will be for the technical resources, including procedures and equipment, medications and supplies.

Will medical billing services company bill for primary and secondary insurance companies?

  • Definitely yes! As a courtesy to the patients, medical billing service companies will submit their bills to insurance companies.
  • If the patient has secondary insurance company, a claim will be sent to the secondary insurance company after the primary insurance company has paid.
  • Patient is requested to supply the pertinent billing information that the insurer may require.

 Why do insurance companies pay only part of patient’s bill?

  • Most insurance plans require that you pay a co-payment, coinsurance or deductible for your health care expenses. Patients must contact their insurance company for specific information about their coverage.

Why do patients receive bills when they have patient coverage?

  • Patients will receive a patient responsibility statement after your insurance processes the bill. The amount patients are billed for is based on what their insurance companies communicate to medical billing service companies on explanation of benefits (EOB).
  • The EOB provides details on how their insurance processed the bill and calculated their responsibility based on each individual insurance plan.

What should patient do if insurance companies pay the bill?

  • Patients must verify if the insurance company has received and processed the claim. If the claim has not been processed, then carefully review your insurance policy or contact the insurance carrier to determine if the services and procedures are covered.
  • The insurance companies will mostly have the most accurate and up-to-date information about your policy and your claim.
  • If the insurance company has questions, please direct them to Customer Service to verify that the most up-to-date insurance information is on file.

Why do patients receive bills for services provided long ago?

  • Medical billing services will process and send a bill to a patient after payment is received from the insurance companies with the confirmation that the balance is owed by the patient.
  • The length of this process depends on how long it takes to receive a response from your insurance carrier, and whether there is secondary insurance.

Do medical billing services companies accept assignment from Medicare?

  • Yes, they do. By accepting assignments, medical billing service companies agree not to bill the patient for any charges Medicare disallows. However, they do bill patients for deductibles, co-insurance and non-covered services.
  • There are instances when Medicare may not cover certain procedures or frequency of treatment. If that applies, patients will be given the Advance Beneficiary Notice (ABN).
  • The purpose of the ABN form is to let patients know in advance that certain services may not be covered and to advise that they may be responsible for payment of these charges.
  • ABN provides them the option to accept or refuse the items or services in cases where Medicare denies payment.

Why do I have more than one account number?

  • Every patient will have a separate account number generated, for each outpatient date of service and each inpatient admission.
  • It enables us to bill for specific charges and diagnosis relating to patient’s care for that date of service and enables the insurance company to apply the proper benefits.
  • For recurring outpatient services such as physical therapy or radiation therapy, one accounting number is generated each month.

What should patients do when their insurance company changes?

  • When patients experience any changes regarding their health insurance, they will have to advise the hospital registrar at the time of service mentioning the same.

Can patients receive medical assistance application?

  • Yes, to receive medical assistance, patients will have to contact customer service of medical billing services.

But payments will purely depend on the policies and regulations of insurance companies. To understand more on payments, please contact your insurance companies and get to know them in detail.

Patient Billing Guidelines:

Helping Patient Qualify for coverage:

  • Hospitals should help uninsured patients to identify potential sources of public and private coverage.
  • Hospitals should assist uninsured patients with applying for coverage or direct patients to other services and supports to help them get enrolled.

Helping Patients Qualify for Financial Assistance

  • Hospitals should have a written financial assistance policy.
  • Hospitals’ financial assistance policy should describe when care may be free or discounted and delineate eligibility criteria, the basis for determining a patient’s out-of-pocket responsibility, and the method for applying for financial assistance.
  • Hospitals should communicate this information to patients in an easy-to-understand, culturally appropriate way and the most prevalent languages used in their communities.
  • Hospitals should publicize their financial assistance policies broadly within the community served (e.g., post on the premises and the website or distribute directly to patients) and share them with other organizations that assist people in need.

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