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Patient Responsibility

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Patient Responsibility

Patient responsibility is a hot topic in healthcare, with major trends impacting and continuing the uncertainty around regulatory changes, healthcare reform, and current and expected changes from a paper-based workflow to more electronic transactions. Patients are increasingly responsible for their own healthcare payments, which can be confusing and frustrating for patients as well as healthcare workers as they attempt to navigate the Affordable Care Act. Patient bad debt and liability are on the rise as the shift away from insurance and towards personal responsibility for healthcare payments continues to accelerate. Healthcare providers are under tremendous pressure around margins and revenue due to this shift and to the extended recovery cycle for revenue. When you need to provide your patients with detailed and highly accurate descriptions of the service, Novigo can help support your needs.

The multitude of changes in healthcare means that there are a lot of surprising statistics, some that are even shocking. If you have an average medical practice, less than 70% of your insurance claims ever actually result in money coming back into your business – meaning up to 30% are lost in limbo. Even if your claims are submitted in a way that is completely clean, there are no guarantees that it will be paid accurately or at all. The rules that payers use are increasingly complex, and include loopholes with the sole purpose of limiting approvals of payments. What this frequently means is that practices do not get paid for the valuable services that they offer to patients on a daily basis. No two businesses are alike, so our denials management practice is personalized to each customer’s revenue cycle and practice needs – but all are focused on how to return needed cash flow to the practice.