Getting Real with Payers and Patients

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Getting Real with Payers and Patients Powered By Docstoc
					Getting Real with Payers and Patients
Brenda Dunham
Health Management Technology; Apr 2009; 30, 4; Docstoc
pg. 28




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DOCUMENT INFO
Description: Increasingly, EDS Pediatrics Group is seeing health plans and employers launch more consumer-centric benefit plans that are requiring the patient to be responsible for a larger portion of their medical bill beyond the traditional $10 or $20 copay to which so many patients have become accustomed. With recent industry data indicating that many practices' total collections from patients can be as high as 20%, and with their practice experiencing similar numbers, they decided in late 2007 to pilot a new real-time adjudication (RTA) program offered by their practice management (PM) vendor, athenahealth, and two of their largest payers, UnitedHealthcare and Humana. They went fully live with the all-payer RTA platform in early 2008, and shortly thereafter began to see significant results, as their group improved at handling the overall amount of self-pay income that is part of their total accounts receivable. This dramatically reduced the administrative burden on their staff as well as the excess paperwork.
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