Healthcare reimbursement is facing some of the biggest changes – and challenges – of the past 50 years.
While in many ways this evolution is a good thing, it does require organizations to fundamentally rethink their revenue cycle. In fact, many providers who have relied on a tried and true method of getting paid – see the patient, code the visit, submit a claim and receive payment from the insurance company for services provided – are having to reconsider their approach.
Traditional payment models are slowly but surely being replaced as the patient becomes a more integral part of the payment picture due to the advent of high-deductible health plans (HDHPs), increasing co-pays and an overall shift to greater patient responsibility. The days when a health insurance payment covered the majority of the patient’s bill are fading, replaced by a blended reimbursement model in which the patient is responsible for paying a larger portion of charges.
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