Do you ever feel like claim denials and delayed payments make it harder than it should be to run a medical practice? Well, you’re not alone. All across the United States, the payment process for healthcare organizations is one of frustration and confusion, but fortunately, there’s help out there – payment resolution services.

These types of collection agencies can be a game-changer when it comes to medical billing, helping you and your practice receive payments from patients or insurance companies without the usual hassle.

Throughout this article, we’ll be taking a closer look at what payment resolution services are and how your practice might benefit from outsourcing one. We’ll also discuss how they actually work and the different types of services available, so let’s get started!

Understanding Payment Resolution Services

Put simply, payment resolution services are any kind of third-party company that specializes in resolving any payment issues in medical billing. They work as an intermediary between yourself (the healthcare providers), insurance companies, and your patient so that they can smoothen out any disputes that may be slowing down your claim/payment processing.

In order to do this as efficiently as possible, these debt collectors will use an array of technology to identify any issues. The specific tech might change depending on the collection agency, but they normally utilize an automated claims processor to streamline the process.

How Do Payment Resolution Services Work?

Whenever your practice has any issues with payments, it’s typically down to a few specific reasons. Whether it’s from denied claims or errors in your coding and billing, it’s the role of payment resolution services to prevent this from happening.

After analyzing data from your medical claims and spotting potential errors, the outsourced service will get in touch with all the relevant parties so any discrepancies can be clarified.

Furthermore, these services aren’t just a one-time fix either, forcing you to return to them every time you have issues. Instead, payment resolution services seek to find the root of the issue, ensuring no further issues occur. They’ll normally do this by analyzing data from your past claims and using it to spot any particular trends that could slow you down in the future.

Once any patterns or trends have been identified, your payment resolution service will liaise with you so you can make the appropriate changes in your billing processes.

Types of Payment Resolution Services

Though they all aim to avoid attorney fees and speed up your payment processing, these services come in a few different forms.

In this part of the article, we’ll be covering all the different options at your disposal and how each service aims to prevent legal action by reducing the complaints filed.

Types of Payment Resolution Services

Denial Management

Firstly, we have denial management. This is one of the most basic services offered by these companies, and they aim to identify and resolve any denied claims. This part is crucial as it allows us to understand what caused the problem in the first place and how you can prevent it from happening again.

It typically involves making phone calls to insurance providers or any other relevant parties, so it’s vital to provide these services with all the data they need to fight your corner. Although this is a fairly time-consuming and complex process, it’s crucial as a healthcare provider that you stay on top of this to avoid any unnecessary write-offs.

Appeals Management

Next up, we have appeals management. This service is actually just a specialized form of denial management that focuses more on any appeals to denied claims. Put simply, while denial management focuses more on correcting the issues that caused the claim to be denied, appeals management aims to challenge the denial through an appeal process.

This normally means checking your claims for any errors or omissions, gathering additional documentation that might help, and ultimately presenting the case to the payer in a formal appeal. Overall, their goal is to overturn any denials you might face and ensure your practice receives the payments it deserves.

Patient Collections

Lastly, there are patient collection services. Essentially, these services work by calling patients directly to collect any overdue payments for their medical treatment. This normally includes everything from billing and follow-ups to helping with consumer payment plans.

As you’re aware, patient collections are a huge part of revenue cycle management, as it’s one of the main ways your practice gets paid for the services you provide. Naturally, this can be a particularly sensitive process, so it’s crucial to avoid abusive language and protect consumers that may be struggling with payments.

Payment Resolution Services With PMN

As the owner of a small medical practice, any delays or denials when it comes to payments can have a significant impact on your business’s success. As such, it’s vital that your practice at least considers outsourcing a payment resolution service to offer assistance – enter PMN.

With over 20 years of experience in the industry, our team can deliver the customized billing solutions needed to match your practice’s unique needs.

At PMN, we consistently operate under the “fair debt collection practices” guidelines, which means we only use ethical and lawful methods to collect any overdue payments from your patients. These patients are your valued customers, and we’ll always treat them with the respect and dignity they deserve throughout the collection process.

However, if a patient refuses to make any payments despite attempts at a peaceful resolution, we’ll pursue any statutory damages in accordance with the law so your practice doesn’t take losses due to unpaid bills or outstanding debts.

And lastly, we’ll always keep your practice’s reputation in mind by ensuring any delinquent accounts aren’t reported to the credit report agencies. This gives your patients peace of mind knowing their credit scores aren’t going to be negatively impacted as a result of a missed payment.

If you’re interested in learning more about PMN, contact us today at (949) 215-5055 or by visiting our office in Laguna Hills, Orange County, California!

FAQs

How Do Payment Resolution Services Help Patients?

By ensuring that their insurance claims are handled in an accurate and prompt manner, the risk of delayed or denied coverage for patients is greatly reduced. This can be a huge factor in reducing out-of-pocket expenses for patients, improving their overall healthcare experience.

Are Payment Resolution Services Cost-effective For Healthcare Providers?

Yes! Your practice’s administrative burden is reduced significantly when outsourcing to a third-party service provider, meaning your practice can save on general practice expenses.