Patient Outreach as a Silent Revenue Killer in Healthcare

In healthcare, claim payments often come through from insurance providers, but what happens when the insurance has settled its portion of the claim, leaving a balance that is the patient's responsibility? For many clinics, the real issue isn’t the delay from insurance companies, it’s the lack of outreach to patients for the remaining balance.

Table of Contents:

1. Introduction: The Silent Revenue Killer in Healthcare

2. Breaking Down the Problem: Why Clinics Miss Out on Remaining Payments

3. How Insurance Payments Alone Aren’t Enough

4. The Real Cost of Missed Follow-Ups

5. FinanceOps: Proactive Solutions to Prevent Revenue Loss

6. Real-World Impact: How FinanceOps Improved Revenue Recovery

7. Key Takeaway

8. Conclusion: The Importance of Proactive Follow-Ups in Preventing Revenue Loss

9. FAQs

According to the MGMA, 2022 report, 56% of healthcare practices reported an increase in days in accounts receivable (A/R), with staffing shortages and the lack of systematic follow-up cited as the top challenges in collections. This statistic highlights the pervasive issue of ineffective follow-ups, a key driver of lost revenue for clinics.

Without effective follow-up after insurance payments, remaining balances often go uncollected, leading to significant revenue loss. Missed follow-ups silently drain cash flow and harm a clinic’s financial health, limiting investment in growth, technology, and patient care. Many healthcare providers lack a dedicated collections team, as they focus on caregiving rather than financial follow-ups. FinanceOps bridges this gap with a structured collections process, ensuring timely payment recovery.

Breaking Down the Problem: Why Clinics Miss Out on Remaining Payments

Once the insurance has paid its portion of a claim, the remaining balance falls to the patient. Unfortunately, many healthcare providers don’t act immediately to collect this balance. The real issue is that clinics fail to follow up with patients once the insurance has settled its portion.

How the Problem Escalates:

By neglecting follow-up, clinics risk financial strain as the uncollected balances continue to age. Unpaid claims pile up and become more difficult to recover, leading to mounting financial pressure on the clinic. Delaying follow-up leads to uncollected payments that could have been easily recovered with a structured and timely approach.

How Insurance Payments Alone Aren’t Enough

Insurance companies may cover the majority of a claim, but there is usually still a remaining balance for the patient to pay. For example, a $400 procedure may be covered for $280 by insurance, leaving a $120 balance for the patient.

Once the insurance pays, it’s the clinic’s responsibility to follow up with the patient for that remaining balance. Without structured follow-up, this balance often goes uncollected. The real issue is that many clinics assume the patient will take care of it, but timely outreach is crucial to ensure the payment is made.

The Real Cost of Missed Follow-Ups

The financial cost of missed follow-ups is significant. Uncollected balances can add up quickly, leading to a substantial loss in revenue. As the claims age, they become harder to collect, and the clinic’s overall cash flow suffers.

Missed Opportunities: Why Delayed Follow-Up Makes the Problem Worse

Every day a balance remains unpaid, the chances of recovering that revenue decrease. Without timely reminders or proactive outreach, patients may forget, ignore, or avoid their financial responsibility. The longer the follow-up is delayed, the harder it becomes to recover payments, leading to mounting uncollected revenue and weakened financial health.

FinanceOps: Proactive Solutions to Prevent Revenue Loss

To address these challenges, FinanceOps offers a comprehensive suite of tools designed to help clinics follow up effectively and recover payments efficiently. By automating reminders and streamlining the collections process, FinanceOps ensures that no claim is left behind.

Proactive Customer Reminders: Ensuring Timely Payments

• Automated Reminders and Follow-Up Notifications: FinanceOps automates the process of sending timely reminders to patients regarding any remaining balance once insurance payments have been processed. These reminders can be delivered via email, SMS, or patient portals, ensuring that patients are always informed about their financial responsibility.

• Impact:

  • Reduces uncollected balances by ensuring patients are aware of their outstanding payments.

  • Improves cash flow by prompting timely payments from patients, minimizing delays or forgotten balances.

Intelligent Payment Collection: Streamlining the Recovery Process

• AI-Powered Collections Automation: FinanceOps uses AI-powered automation to assess claim statuses, patient behaviors, and payer patterns. This intelligent system identifies the optimal time and approach to follow up on outstanding payments, ensuring claims are managed effectively.

• Impact:

  • Increases recovery rates by automating follow-ups based on patient data and past payment history.

  • Reduces manual intervention, allowing the clinic to focus resources where they're most needed, while improving efficiency and timeliness of collections.

Resolution Centre for Complaints: Handling Disputes and Complaints

• Real-Time Tracking of Complaints and Disputes: When patients dispute their remaining balance or raise concerns, FinanceOps’ Resolution Centre offers real-time tracking of these issues. It allows clinics to quickly and efficiently resolve disputes without interrupting the collections process.

• Impact:

  • Ensures disputes are handled promptly, preventing delays in payment recovery.

  • Helps maintain positive patient relationships by providing a clear and responsive dispute resolution process.
    
    

• Efficient Dispute Management: Gives healthcare teams real-time visibility into issues, enabling fast resolution and uninterrupted collections, which improves payment recovery speed.

Real-World Impact: How FinanceOps Improved Revenue Recovery

Case Study: A Healthcare Clinic’s Revenue Turnaround: A healthcare provider with a 15% claim denial rate was struggling with uncollected balances due to delayed follow-ups. After implementing FinanceOps, the clinic automated reminders, leveraged AI-powered collections, and significantly improved their follow-up process. In just 90 days, they were able to recover 40% of previously uncollected balances.

Key Metrics:

• Before FinanceOps: 30% of unpaid claims went uncollected, and aging claims were increasing.

• After FinanceOps: 90% of unpaid claims were recovered, with collections efficiency improving by 50%.

Results: FinanceOps helped the clinic convert missed opportunities into recovered revenue, improving their cash flow without adding extra overhead.

Key Takeaway: FinanceOps bridges this gap by automating reminders and streamlining collections, ensuring timely payment recovery and improved cash flow.

Conclusion: The Importance of Proactive Follow-Ups in Preventing Revenue Loss

In conclusion, the lack of proactive outreach after insurance payments is a major source of revenue loss for healthcare providers. While insurance delays are part of the issue, the real problem is the failure to follow up with patients for the remaining balance.

By using FinanceOps, healthcare providers can automate patient reminders, streamline collections, and improve their cash flow. With AI-driven automation and real-time dispute resolution, FinanceOps ensures that healthcare providers recover more payments, faster.

Don’t let missed follow-ups drain your clinic’s revenue. 

Book a demo today and see how FinanceOps can transform your collections process.

FAQs

1. How does FinanceOps help recover unpaid balances? 

   FinanceOps automates reminders and follow-ups to ensure patients are promptly notified of their outstanding balance, helping clinics recover revenue more efficiently.

   
   

2. Can FinanceOps help reduce the burden on AR teams?

   Yes! By automating follow-ups and using AI for collections, FinanceOps significantly reduces the manual workload for AR teams and improves collections efficiency.

   
   

3. What happens if a patient disputes their balance?

   FinanceOps offers a Resolution Centre, which allows real-time tracking and resolution of disputes, ensuring that collections continue without delays.

   
   

4. How does FinanceOps improve cash flow forecasting?

   By ensuring timely follow-ups and improving payment recovery, FinanceOps provides more accurate revenue projections, reducing reliance on guesswork in cash flow forecasting.

   
   

5. Is FinanceOps HIPAA compliant?

   Yes, FinanceOps is HIPAA compliant.