How Revenue Cycle Management Services To Billing Benefit For US Healthcare Organizations Individual Or Group Of Practices.

Payment collection is often one of the most difficult aspects of being a doctor. It is also quite tiresome to manage the bills and settlements of patients, which is just another pile-on for doctors. This deviates them from their basic duty, which is treating patients. 

A revenue management system specially designed for hospitals and doctors makes the task easier and be worry free of the payment aspect. Healthcare providers often end up conflicting with payments, patients, and insurance agencies, but not anymore. As a matter of fact, the revenue management system processes payment transactions safely to doctors within a year. So let us know more about the payment collection system and its benefits.

Explanation of Benefit (EOB)

The benefit explanation is a document the patient receives after the treatment is completed. The bills issued by the hospital go to the insurance provider of the patient, where it is analyzed and broken down. As per the insurance policy and premium, the insurance provider pays up to a certain amount of the bill issued. It can even be 100% of the total bill amount. After the clearance of payment, an EOB is generated by the insurance company. 

The EOB clearly explains to the patient all the breakdowns that they need to know, such as the hospital charges, the amount paid by the insurance company, and the total amount due. This document helps the patient understand the breakdown of charges, based on which they understand whether or not they are getting all the insurance benefits. They also can note down the hospital charges. 

Problems Faced Due To EOB

With the explanation of the benefit, the patients receive a document based on which they are supposed to pay an amount to the doctors or the hospitals. This becomes a manual process that has many loose ends. If there is a delay in any step, such as delay in insurance clearance, delay in EOB issue, and of course, delay in payment by the patient, as an end result, the doctor or the hospital faces problems. This manual process creates a big amount of mess when it comes to payment clearance. The patient-physician encounter with this system is quite tedious.

Benefits of AI-enabled Payment Transactions

To help save doctors from this tedious process of EOB payment clearance, an automated payment posting solution comes into the picture. This advanced healthcare management eliminates all the manual processes, which results in a completely automated process. In addition, the high-end intelligence working system also helps eliminate any errors that may come along with the manual process. Thus, any scope of delay is completely eliminated. 

The bot system of automated payment solutions recognizes over 3000 payers and payer-specific EOB formats. Based on this, it segregates and defines EOBs in batches by applying multiple OCR engines. Further, the system also compares the captured data against one another. This system helps to achieve a higher posting accuracy. Since it is an automated process, any manual errors, such as quality issues of images, are also eliminated. Yet still, there is a scope for intervening and conducting manual operations for exceptional cases. 

The healthcare provider has to get several bills cleared from their patients, such as consultation charges, right from the first time they visit. However, the insurance provider doesn’t need to always cover it. In such cases, the doctors are expected to take care of and verify the same. They further need to ensure that the patient pays the bills. 

But not if you are using the SIXA healthcare management service. This billing company keeps track of all your bills right from the time any patient steps inside the clinic or the hospital. They generate bills and keep track of the insurance company for bill clearance. If the bill is not cleared, the bot ensures that the patient is informed of the same. Further, the system keeps till the dues are cleared. 

The automated process of SIXA helps the payer and the doctor to be clear of any manual error and get rid of due diligence. In addition, this system helps the hospital understand the exact outstanding amount that the patient has to clear. Compared to the manual operating system, this process helps to streamline the process of payment. Whereas on the other hand, the bills are often tossed between the payer and insurance company leaving the healthcare system hanging in the middle.

SIXA has developed a payment collecting system using advanced technology and artificial intelligence. Their advanced technology helps the doctors get their payment issued by the Explanation of Benefit (EOBs) after getting it cleared from the patients. 

Footnote

With the advanced technology of SIXA, doctors need not worry about the business aspect, such as payment collection of running the hospital. Rather, they can focus on what they do best, treating the patient, without worrying about the payments.