Richard Soper on Timely Payments for Physicians
Ever since I became a physician, I,
Richard Soper, know very well that reimbursement for the health care system in
the United States is very complicated. There are federal payers, state/federal
payers, private for-profit insurance companies, non-profit insurers, and
private insurance companies. The complexity comes with costs. Both hospitals
and physicians are required to hire people just to process all those different
payers. Recent studies show that payers more often reject the bills submitted
to them by the physicians’ offices.
Just like medical coding, medical
billing seems large and complicated. Eight steps, which include the following:
patient registration, confirmation of the financial responsibility, patient
check-in and check-out, checking for coding and billing compliance, preparing
and transmitting claims, monitoring payer adjudication, generating patient
statements o bills, and assigning patient payments and arranging collections,
comprise this billing process. Whenever
a patient is delinquent in their pay, it is the biller's responsibility to
reimburse for the services provided by the healthcare provider. The billers
should be the one to contact the patient directly, send follow-up bills, or
enlist a collection agency since these are not and should not be the work of
physicians.
Up to now, I, Richard Soper, believe
that this dilemma of receiving payment for their services has been a burden for
physicians' offices. Responding to payment denials costs effort and money.
Physicians are also sometimes required to take time away from patient care to
explain why they indicated specific services. To make things worse for
clinicians, even when state/federal payers do reimburse for physician services,
it takes longer than usual.
People from the United States of America
deserve fair health care coverage, whether from private or public insurance
agencies. However, it is only just and equitable that American physicians also
get timely payment when they provide needed healthcare services to their
patients.
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