In the spirit of to our January 7, 2016 blog, we want to continue with the New Years’ resolution theme by concentrating on other important tasks every Post-acute Long Term Care AR manager should address. The following checklist can be helpful in steering your accounts receivables in a cash-positive direction for 2016:
- Contract Management – Perhaps this is a good time to blow the dust off those payer contract file folders. Get to know the details and the impact they will have on cash flow for the next year. Do they include changes for 2016, such as reimbursement rates and contractual write-offs? Being familiar with and responding to such details can help AR managers more reliably predict payment requirements, amounts, and timing.
- Co-insurance and deductibles – The ruleof thumb is if insurance is going to change, it will be at the beginning of the year. Specifically, check each payer’s copayments and deductibles. They typically seem to parallel Medicare guidelines which went into effect January 1st. The following table highlights some of these changes:
2016 Medicare rates at a glance |
|
Part A Skilled Nursing Facility Coinsurance |
$161 per day for days 21- 100 of Part A coverage |
Part B Deductible and Coinsurance |
Deductible - $166 Coinsurance – no change |
Part C Rates |
The rates and other billing terms are stipulated in the Medicare Advantage contracts |
- Patient liability – Not many states have fiscal years beginning on January 1, but in the event the states your facilities operate in do, then knowing what the patient liability rates will be and communicating them to Medicaid residents’ responsible parties will be helpful to collections. Even if the Medicaid fiscal year end is later, now may be a good time to review anticipated changes.
- Contract folder and tickler file - If you haven’t already, we highly recommend that you set up a tickler file to effectively manage and track your payer contracts. Whether the tickler file is a traditional binder with physical folders or an electronic version, this is a good time to bring them up to date and to calendar critical changes and negotiation/renewal dates.
This list is small, but important. It will help you address not only these important revenue cycle management tasks, but also other tasks tied to your 2016 billing and collection goals.