CASE STUDY: Increasing Outside Medical Collections for Emergency Physician Groups

Amid the clamor of election year rhetoric surrounding healthcare reform, and in the face of constitutional challenges to the Patient Protection and Affordable Care Act set to be decided–at least in some form–by the US Supreme Court in late June, it’s sometimes easy to forget that healthcare organizations across the country are still tasked with providing quality medical care on a day to day basis. That should be a “no brainer,” but for many providers, meeting patient needs is only part of the battle; getting paid in a timely manner for the services they render often requires as much effort as delivering care.

As healthcare providers work to reduce days A/R and boost cash flow to cover operating expenses, they are aided by a network of third-party service providers—like billing companies, contingency debt collection agencies, and revenue cycle management firms—that partner with them to recover delinquent patient accounts. Professional Medical Billing (PMB), headquartered in Fort Wayne, Indiana, is a specialized reimbursement management company that serves independent, fee-for-service emergency physician groups. Like the physicians it supports, PMB was stymied by economic conditions that made the collection of past-due medical receivables on behalf of emergency physician groups an arduous task.

PMB engaged DECA Financial Services, a nationally licensed healthcare collection agency, to evaluate its clients’ delinquent healthcare accounts, assess the in­ternal collection processes in place, and partner with PMB to develop an analytics-driven solution to improve outside collection returns.

DECA Financial Services and insideARM.com have just published a new Case Study on the various organizational challenges that healthcare providers and their recovery specialist partners face in today’s economy.

In the initial phases of the campaign, DECA Financial Services identified a number of barriers to PMB’s clients’ success, including:

• Significant increases in the number of overdue emergency medical bills
• Self-funded plans that had run out of money
• Inadequate skiptracing solutions
• Ever-changing eligibility for employer-sponsored, private market, and government health plans

The Case Study, entitled Increasing Outside Medical Collections for Emergency Physician Groups, examines healthcare collection challenges from three angles: broad trends in U.S. economy impacting healthcare collections, technological inexperience or deficiencies related to right-party contacts (RPCs), and internal resource limitations impeding stated liquidation objectives.

During the course of the engagement, DECA Financial Services was able to increase PMB’s clients’ outside collection re­turns by 50 percent over the entire prior year’s results in only six months.

To learn more about the specific objectives DECA Financial Services successfully achieved for PMB and its clients, click here for a free download of Increasing Medical Collections for Emergency Physician Groups.

Michael Klozotsky is the Chief Content Officer at insidePatientFianance.com and insideARM.com. Follow insidePatientFinance on Twitter @insidePF.