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Tyler Williams, Director of Strategy, AR Optimization, ZOLL Data Systems | January 1, 2019

4 reasons your self-pay receivables underperform. And what to do about it!

Traditional methods to manage self-pay accounts are increasingly inadequate and fraught with failure. Here are four common mistakes providers make when processing self-pay receivables:

  • Data quality – Deficient data integrity. Demographics and insurance information are missing or incorrect.
  • Forecasting – Lack of receivables forecasting tools and analytics. Providers are unable to segment their self-pay received to determine a likely yield
  • Compliance –Distraction created by federal and state bookkeeping requisites. Another day, another new requirement.
  • Labor-intensive processes – Applying the same recovery tactics to each account. Labor is costly. Wasting valuable time on self-pay accounts that may never yield reimbursement is a lose-lose strategy.

For greater efficiency, and self-pay value, new approaches to managing self-pay accounts must be considered. There are simply too many accounts to continue using the same-old, inefficient process. One of these strategies is to score and prioritize your self-pay accounts.

Score and prioritize self-pay accounts 

Understanding the five core attributes that affect reimbursement and account performance is the first step to successfully targeting staff resources and actively managing the revenue cycle. Self-pay accounts can then be segmented by score value. Based on those score values, managers are empowered to select the best pathway for maximizing value from their receivables.

5 core attributes that affect self-pay A/R performance

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  1. Demographic Verification – Validate guarantor’s contact information
  2. Insurance Discovery – Search self-pay for hidden payor coverage
  3. Self-Pay Analysis – Define propensity to pay and who qualifies for financial assistance
  4. Insurance Verification – Ensure first claim adjudication—everytime
  5. Prior Authorization – Determine reimbursement requirements

For details about self-pay receivables and how to set a new A/R strategy, request a demo here.

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More About the Author:

Tyler Williams, Director of Strategy, AR Optimization, ZOLL Data Systems

Tyler Williams is a successful entrepreneur whose experience in healthcare reimbursement, business, and data combine to provide deep industry insight into the challenges faced by medical providers and healthcare professionals. As the RCM Director of a large, pediatric emergency medicine firm in the 1990s, Tyler experienced the challenges of bad payer tactics and obtaining accurate and timely payer information from the patient. His struggles inspired him to pioneer what the industry now knows as insurance discovery and healthcare identity (or demographics verification) and to launch the company, Payor Logic. Under Tyler’s leadership, the company grew into a multi-million-dollar organization serving more than 90% of the ambulatory outpatient market. Payor Logic was acquired by ZOLL Data Systems in 2019. Today, Tyler serves as Director of Strategy, AR Optimization for ZOLL Data Systems and ensures that providers have access to high quality data reflecting the patient’s unique financial characteristics to enable optimal and compliant reimbursement. Tyler is a nationally recognized speaker on AR optimization and innovation. He is a past board member of Steppingstone Ranch, a nonprofit equine therapy program serving at risk teenage girls.