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Hospitals face over $45 billion (6.1% of total expenses) in bad debt in 2012, which is an 11.6% increase from 2011.[1] We estimate physician groups have 11% bad debt, which is over $77 billion. With growth of high deductible plans, bad debt is increasing and creating major cash flow shortages.  A June report from Citi Enterprise Payments, part of financial services giant Citigroup, found that patient financial responsibility under their health plans is now approaching the 15% to 20% range, when it was previously in the 6% to 10% range. An analysis from Citigroup projects that bad debt could reach $200 billion by 2019.[2]

According to the 2013 Deloitte Center for Health Solutions survey of major US companies, 54% of employers are considering offering high-deductible health plans as the only benefit option in 2014. Already, 17% of employers offer high deductible plans as the only options, a 31 % increase over 2012. Hospitals expect more patients will have greater out-of-pocket costs under high-deductible plans offered through the new health insurance exchanges under the Affordable Care Act.  When consumers pay more for their healthcare, they often make more cost-conscious choices. However, this wave of high deductibles means a significant change in cash flow for physicians and hospitals. It is time to implement a new solution to better manage billing.

Changing the Payment Process

To protect cash flow, reduce bad debt, and improve communications with patients concerning their medical financial responsibly, Enablemyhealth delivers the UpFront™ solution. UpFront empowers your front office to collect what is due prior to or on the day of a visit or procedure and enables patients to be better informed about expenses their insurance benefits do not cover. UpFront empower Patients to realize their potential medical expenses, understand their medical benefits, and manage their medical expenses for all their medical care. With Upfront patients enter demographic and insurance information, request appointments, validate benefits, estimate and validate medical expenses, pay medical expense, track medical expenses, and securely communicate with groups, hospitals and clinics. Never before has one solution dramatically changed the physician-patient financial relationship in such a mutually beneficial way.

Eliminate Surprise Medical Bills!

Unexpected medical bills have become the norm in healthcare. With the enactment of the Affordable Care Act, healthcare plans have become very complex. Patients get upset and this negatively impacts patient satisfaction and even patient care. Physician groups and hospitals are then in the position to collect payment from a patient who doesn’t think they owe. This is a broken process that requires a fundamental change in patient billing – we call it the UpFront process!

Moving the Process UpFront!

Providing patients medical estimates prior to medical services is beneficial to patients, medical groups, imaging centers, and hospitals. Patients know how much the medical service, procedure or test costs them prior to having the service or procedure, so they can plan for any out of pocket expense that their insurance will not cover. Physicians and hospitals are able to offer payment plans and collect estimated payments before or at the time of service, which keeps administrative costs low and allows patients to spend less time in the office.

Collections Management and Notification

Entering insurance, validating insurance, and collecting patient payments is a laborious process. Enablemyhealth checks insurance and engages the patient and staff throughout the entire process with our intelligent notification engine that calls, texts, and emails to entering or reviewing key insurance information and notifying them to make payments on outstanding balances.  No more worrying about insurance not being valid or required authorizations, or invalid credit card – Enablemyhealth alerts the patient and staff until the problem is resolved. All of the notification messages and settings are customizable.

[1] ACA International’s Top Collection Markets Survey*, Jan. 1 – Dec. 31, 2013

[2] Modern Healthcare August 17, 2013

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