Holistic practices face unique circumstances when it comes to medical billing due to the ever-shifting regulatory guidelines that stipulate which holistic health services are covered by insurance, and which services remain strictly out-of-pocket. With patients paying more for their own care and insurers looking for practically any reason to deny claims (and save themselves money), monitoring collections closely is critical for staying on top of a holistic practice’s financial health and insulating it from potential changes in the regulatory landscape.
A holistic practice’s net collection rate is essentially a performance metric that measures how effective the practice is at collecting all legitimate forms of payments for services, which are typically the amount owed after all insurance company adjustments are made. The net collection rate will reveal deficiencies in this process. If a practice is struggling to collect revenue due to bad debt, late filings, coding errors, or claim underpayments, it will have a low net collection rate.
Since net collection rate is directly tied to a practice’s revenue stream, it’s one of the most important performance metrics to monitor. Typically calculated on a quarterly basis, the rate represents a snapshot of financial health and efficiency. A low net collection rate should be treated as an urgent priority because it indicates that the practice has a persistent problem when it comes to gathering revenue, which could indicate an organizational inefficiency or an issue with patient relations and communication.
For many holistic practices, assessing net collections on a quarterly basis may not be frequent enough to identify potential fluctuations or problems before they start to eat into the practice’s revenue. Calculating and monitoring net collection rate on an ongoing basis, whether it’s monthly or every few weeks, can help the practice flag issues quickly and prevent outstanding collections from snowballing to the point where they become unmanageable.
It starts with understanding how to assess a holistic practice’s net collection rate, which involves several important steps:
A 96% net collection rate is generally considered ideal across the healthcare industry, regardless of practice type. This applies to holistic practices as well. If the rate is closer to 90% (or lower), the practice is definitely leaving revenue on the table that it should otherwise be collecting.
The whole purpose of monitoring net collection rate is to identify these problems, or, to put it another way, take advantage of opportunities. A low score indicates that some issue is getting in the way of efficient payment collections. There are a few common culprits that bring down net collection rates for a holistic practice:
Depending upon the source of the problem, there are a number of solutions that a holistic practice can implement to boost its net collection rate.
One of the easiest steps to take is to collect 100% of copayments and deductibles from patients at the initial point-of-service. This ensures that no one walks out of the office with an outstanding bill and avoids the resulting hassle of collecting payments afterward, which can be just as inconvenient for the patient as it is for you or your staff. Setting up appointment reminders that inform patients they must pay for holistic services up-front is essential for making this strategy effective. If a patient is unable to cover the cost at that time, the appointment can be rescheduled or other payment options can be discussed.
Many patients who seek holistic medical care may not understand which services their insurance will cover and which services they will be responsible for paying. This can create a great deal of confusion when it comes to billing. To avoid any surprises, either at the point-of-service or in the event of a denied claim, it’s important to educate patients about the unique nature of holistic medical services and how their specific insurance plan regards them. Providing a brochure or reference sheet can be helpful, but patients may have many questions that require more detailed explanations. Having a staff member with the expertise and resources to field these questions can help to reduce confusion about how the claims and payment process works for holistic practices.
Expanding payment options requires some investment on the front-end, but it can have a major impact on net collections over time. Mailing out a billing statement and asking patients to write a check was an inefficient collection strategy 30 years ago, and it’s even less efficient today. As consumers, patients are accustomed to being able to pay for services in a variety of ways, whether it’s by credit/debit card, through an online portal, or via a mobile app. For some patients, an installment plan might be the only way they can realistically afford holistic healthcare services that aren’t covered by their insurance provider. By providing a variety of payment options, patients are far more likely to find one that suits their needs and pay their bills promptly.
When evaluating the reasons for a low net collection rate, it’s easy to assume that the problem stems from patients not paying their bills. In many cases, however, the issue has as much to do with the way a holistic practice handles its billing. Since these offices typically don’t have as much staff support as the average healthcare practice, holistic care providers are sometimes forced to wear many different hats. That can lead to administrative tasks like preparing insurance claims or billing patients being put off in favor of much more urgent tasks.
Unfortunately, time is of the essence when it comes to revenue collections. Taking too much time to submit an insurance claim could lead to a denial, and patients may be less inclined to pay a bill promptly when it takes a long time to arrive in their mailbox. More importantly, filing an insurance claim is a very detail-oriented process, so even the slightest error could result in a claim being denied. Putting a system in place that files claims accurately and promptly (as well as bills patients consistently) is essential for any holistic practice hoping to improve its net collection rate.
Whatever the causes of a low net collection rate, partnering with a reputable holistic billing service is one of the fastest and easiest ways to turn this key revenue metric around. An experienced billing service can overhaul the way a holistic practice prepares and submits claims to payers to minimize the rate of denials. Turning the billing process over to a third party also frees up time for office staff to focus on providing the best service and care possible. Instead of spending hours on the phones trying to collect outstanding payments, they can focus on expanding the holistic practice’s patient base and improving services to better retain the patients it already has.
Holistic Billing Services has years of experience handling coding and billing issues for holistic health providers, with a special focus on acupuncture, chiropractic, and massage practices. We understand that each practice is unique and requires a customized solution that aligns with its long-term goals. That’s why we work closely with our clients to help them set up the solutions that meet their specific needs and allow them to deliver the best holistic care possible. To find out what we can do for your holistic practice, contact our team today for a consultation.
At Holbie, we offer complete and innovative Holistic Billing Services for acupuncture, massage therapy, and chiropractic providers.
At Holbie, we offer complete and innovative Holistic Billing Services for acupuncture, massage therapy, and chiropractic providers.
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