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phone, or emails, they expect to be acknowledged and responded to within a timely manner. 4.) Courtesy: Having polite and helpful staff members, who relay friendly body language and facial expressions. 5.) Credibility: Building trust with customers, advertising accuarat3e information, and following through with promises. 6.) Consistency: Establishing a pattern of exceptional behavior and maintaining it. (Allen, 2013)Third Party PoliciesWhen developing billing guidelines for patient financial services (PFS) personnel and administration, it is important to know the policies of third-party payers, to ensure maximum reimbursement. Medical billing and coding specialists deal with sensitive information on a daily basis and handle provider, patient, and insurance information that must be kept confidential at all
11times. Understanding the third-party policies and aligning your billing guidelines with those policies, ensure that patient information is kept confidential and that the healthcare organization has guidelines in place to receive reimbursement through each payer effective and efficiently. The billing guidelines put in place will include important privacy, security, and filing-related rules that one will need to know when submitting for reimbursement. PFS can offer patients a variety of financial services such as online bill pay, financial assistance, and online requests for estimated out of pocket procedure costs. Offering services like this means that the financial information provided by the healthcare organization must be accurate with the third-party payers and their policies. The billing guidelines developed should also address claim development and submission, medical necessity definitions, anti-kickback and self-referral concerns, bad debts, and retention records. Key Areas of ReviewFirst, verifying insurance information is one of the most important areas to review. Without having the patient’s correct insurance information such as, insurance company name, subscriber ID, effective date, and copays; a healthcare organization would not be able to bill for the services provided. Second, it is important to collect co-pays at time of visit; it saves the organization the cost of sending out bills and the wait time on collecting that revenue. From a customer service aspect, it is beneficial to ask the patient how they would like to pay for their co-pay, rather than asking if they would like to pay for their co-pay. This gives the patient the optionof how to pay rather than if they would like to pay or not. The organization is more likely to never get reimbursed for that co-pay if they give the patient the option to pay or not. Second, providing patients with financial counseling. Insurance companies won’t cover specific services or procedures so it is important for patients to know before receiving those services. The
12healthcare organization should have contact information available for a financial counselor or program that can potentially assist patients financially. Financial counselors assess a patient
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Health care provider, healthcare organization, Health maintenance organization