As patients shoulder a greater financial burden of healthcare costs, care providers are becoming more interested in assessing a patient's ability to foot the bill. Falling reimbursement rates at healthcare systems have revenue cycle service providers examining new ways to assess and deliver on payment likelihood.
Jordan Levitt, founding partner of PayorLogic — an industry provider of revenue cycle solutions — spoke with Becker's Hospital Review about the current state of the payment assessment field, and what PayorLogic hopes to change about it.
"The definition of payer logic has changed so much since the company's foundation," says Mr. Levitt. "Propensity to pay now describes a patient who wants to pay, may not be able to pay on the first try and/or has become inundated by so many different medical bills they don't know what to pay," Mr. Levitt says.
Traditionally, healthcare providers received reimbursement for an episode of care from a single party. Since the introduction of the Affordable Care Act, however, Mr. Levitt says provider reimbursements now consist of a blend of payers — patients, commercial payers and government payers, among others.
The way providers continue to assess propensity to pay must reflect this co-mingling of information and diversification of payment channels if they are to maximize their reimbursement potential, according to Mr. Levitt. By manipulating the billing sequence, providers may alter a patient's ability to pay and improve their chance to receive reimbursement in total.
"Hospitals and providers currently operate under the belief that the first party to send their bill will be the first, or most likely, to receive a check," Mr. Levitt told Becker's Hospital Review. "By waiting to issue a medical bill until a majority of a patient's deductible has been met, however, providers may increase the chance of receiving reimbursement in full from the payer."
A small percentage of care providers currently use self-pay assessment tools, says Mr. Levitt, leaving the door open for significant growth and refinement in the self-pay service industry. PayorLogic is focused on automation, product integration and contract expansion within the new year.
PayorLogic currently provides revenue services to more than 14,000 providers nationwide.