Changing Reimbursement Models Affect How Providers Get Paid

 In Engagement Strategy, Revenue Cycle

The patient is becoming a more integral part of the payment picture

Healthcare reimbursement is changing to better meet the needs of patients. Many providers who have relied on a proven method of getting paid–see the patient, code the visit, submit a claim, and receive payment from the insurance company for services provided–are reconsidering their approach.

Traditional payment models are being replaced as the patient becomes a more integral part of the payment picture due to the advent of high-deductible health plans, increasing copays, and an overall shift to greater patient responsibility. The days when a health insurance payment covered the majority of the patient’s bill are fading, replaced by a blended reimbursement
model in which the patient is responsible for paying a larger portion of charges.

While some practices have begun laying the groundwork for a blended model, others have not started to address the growing importance of patient payment. A Change Healthcare provider poll revealed that only 23 percent of practices currently require payment beyond co-pays at the time of service. On the other hand, 19 percent don’t currently have a process in place to take patient payments, and 34 percent are not sure of the impact of increased patient responsibility.

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Changing Reimbursement Models Affect How Providers Get Paid

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