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Medicaid Replacement Plans

American Ambulance Association – August 2017 Medicaid billing in emergency medical services is unavoidable. From trauma trips to non-emergency transports, ambulance providers face a multitude of hurdles when trying to identify, verify and bill the correct payor for Medicaid patients.

Making Self-Pay Strides in Emergency Medicine

RCM Answers – April 2017 To stem the rising tide of bad debt accounts and the productivity loss physicians face when trying to manage them, providers are exploring new ways to streamline the entire process.

Time to Automate

American Ambulance Association blog – April 2017 Finding fast, efficient ways to verify demographics and discover insurance coverage for patients.

Solving the Unique Revenue Cycle Challenges of EMS Providers

HFMA Revenue Cycle Strategist – April 2017 IT Common front-end hurdles wreak havoc for back-end EMS staff efficiency.

Patient engagement:  more moving parts than many realize

Healthcare IT News – March 2017
IT Vendors are helping providers make inroads toward better engagement by targeting their tools toward specific episodes and encounters across the care continuum.

RCM tip of the day: Reduce cost to bill by segmenting patients’ propensity to pay

Becker’s Hospital CFO – November 29, 2016
Patients are taking on more of the healthcare cost burden as high deductibles increase in popularity. Given this trend, hospitals and health systems continuously strive to improve patient communication and collections, as well as reduce costs

Maximizing Revenue from Commercial Payers

Page Wolfbert & Wirth – November 10, 2016
Commercial insurance- once a bright spot in EMS billing because of simplified claims processing and higher payment rates- has become increasingly complex.  Coverage, claim submission requirements, and payment rates are different for every payer which means there is no one size fits all approach to commercial insurance.

Meeting revenue cycle goals by simplifying the complexities of self-pay management

HCPro – September 1, 2016
The cost of healthcare is quickly rising across the nation, and patients are shouldering the majority of the price increases through higher deductibles and out-of-pocket expenses as expenditures continue to shift from employers to patients

HIT Think How revenue cycle technology can rescue EMS payments

Health Data Management – August 12, 2016
Revenue cycle management for emergency medical services (EMS) providers can be summed up in one word: retroactive.

Meeting Revenue Cycle Goals by Simplifying the Complexities of Self-Pay Management

Revenue Cycle Advisor – July 25, 2016
The cost of healthcare is quickly rising across the nation and patients are shouldering the majority of the price increases through higher deductibles and out-of-pocket expenses as expenditures continue to shift from employers to patients.

Preventing Big Data Pain Points During a Healthcare Encounter

HealthIT Analytics
When it comes to the healthcare space, the term “big data” may seem needlessly redundant.  After all, each and every patient generates a staggering amount of information each second they’re in the clinical setting.

Managing the Self-Pay Surge

Journal of AHIMA – March 2016
Membership required

Hospitals increasingly using credit checks to understand whether patients will pay

Healthcare Finance News – March 16, 2016
Hospitals are increasingly turning to credit checks to determine both an individual’s ability to pay and to mine data on their patients’ population health.

PayorLogic: Is it possible to change a patient’s ability to pay?

Becker’s Hospital CFO – January 4, 2016
As patients shoulder a greater financial burden of healthcare costs, care providers are becoming more interested in assessing a patient’s ability to foot the bill. Falling reimbursement rates at healthcare systems have revenue cycle service providers examining new ways to assess and deliver on payment likelihood.

How will the DME prior authorization rule affect revenue cycles?

Becker’s Hospital CFO – December 30, 2015
The latest DME prior authorization rule has some healthcare experts furrowing their brows, concerned the regulation’s focus on cost control may come at the expense of efficient patient care.

25 things to know in revenue cycle management

Becker’s Hospital CFO – December 22, 2015
The healthcare revenue cycle is just beginning to feel the effects of consumerism as employers, providers and patients focus on containing healthcare costs.

The New and Emerging Self-Pay Patient: Effects of the Affordable Care Act on Emergence Medicine

Emergency Department Practice Management Association
In an era of high deductible health plans (HDHPs) and skyrocketing copayments, patients-and sometimes their providers-oftentimes bear the brunt of rising healthcare costs. In fact, one could argue that the notion of “self-pay” is no longer specific to those without insurance. That’s because patient financial responsibility is at an all-time high even for those who are technically insured.

Patient Financial Clearance: Ensuring a Successful Revenue Model in Emergency Medicine

Hospital EMR and EHR – July 2, 2015
In emergency medicine, most providers know this to be true: medical triage and rendering healthcare services is often the easy part. Financial clearance and obtaining payment is the challenge. This is particularly relevant in light of the Emergency Medical Treatment & Labor Act (EMTALA) that ensures public access to emergency department (ED) services regardless of one’s ability to pay.

Increased Deductibles Create More Revenue Cycle Challenges

RevCycle Intelligence
The ability to collect payment from patients has changed dramatically with the recent proliferation of high deductible health plans (HDHPs). Increased deductibles mean more revenue cycle challenges.

Don’t Let Self-Pay Collections Slip Through Your Fingers: Three New Strategies to Consider

Bloomberg BNA – September 23, 2015
A decade ago, most organizations defined self-pay patients as those who presented for healthcare services without proof of insurance coverage. Fast forward to today’s post-Affordable Care Act (ACA) environment and you’ll be hard pressed to find many organizations that still use this definition. Why?

Zoll and Payor Logic to Help EMS Agencies Optimize Payment Revenue

May 10, 2017 – ZOLL® Medical Corporation’s Data Management division and Payor Logic announced today a cooperation to help EMS agencies simplify the EMS billing process and optimize revenue through a new solution called RescueNet® Billing Pro.

TriCap Technology Group and Payor Logic Partner to Deliver a Single Point of Access Patient Receivables Solution for Healthcare

March 29, 2017 – Today, TriCap Technology Group, LLC and Payor Logic, Inc., combined their technologies to deliver the market’s most streamlined patient receivables solution through a single point of access for the healthcare market.

Payor Logic Drives More Revenue for Puckett EMS

August 5, 2015 – Georgia Ambulance Service Provider Finds Insurance Coverage for Self-Pay Patients

Payor Logic’s Mark Owen Elected to EDPMA Board of Directors

March 24, 2015 – Owen serving as Co-chair of Quality, Coding and Documentation Committee for Emergency Department Practice Management Association

Key Trends in Self-pay

Healthcare faces dramatic, historic increases in self-pay accounts; both in the value of these accounts, and their sheer number.

EMS

Drive more revenue

Hospitals

From uncompensated care to cash

5 Way Self-Pay

A cost effective way to manage the new self-pay