Healthcare Collection & Medical Receivables Resources

Medical receivables are the amounts owed by third-party payers to healthcare providers. The party owing the money can be commercial insurance companies, HMOs, Medicare and Medicaid, or patients (if there is an outstanding balance after insurance or another payer has paid its portion). After a certain period of delinquency, healthcare providers will often outsource the accounts to collection agencies.

Much of the content on this page was brought over from insidePatientFinance.com, a sister site of insideARM focused on healthcare finance.

U.S. Department of Health HIPAA Information page – An information repository on the Health Information Portability and Accountability Act (HIPAA) from Health and Human Services, the federal agency that administers the law, including the HIPAA Privacy Rule and the HIPAA Security Rule.

U.S. Centers for Medicare & Medicaid Services – ICD-10 - ICD-10 is the global medical coding standard for classifying diagnoses and reasons for visits in the healthcare setting. It is administered in the U.S. by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS).

2014 Medicare Physician Fee Schedule -The MPFS lists the more than 7,400 unique covered services and their payment rates to physicians in the U.S.

Three Strategies to Shrink Bad Debt: Presumptive Charity Care, Propensity to Pay and Partner Management

Whitepaper: Revenue Cycle Impact Analysis – As the Affordable Care Act brings more people into the healthcare system, healthcare providers will face lower reimbursement rates along with an increase in the number of patients who lack the financial capacity to pay their balance at the time of service or prior to write-off as a bad debt.

Whitepaper: The Perfect Medical Bill, Paid Perfectly – This paper sets a general framework for the discussion your organization needs to have to in order to identify weaknesses across your receivables operations, and choose a course of action to collect more cash, quickly.

Whitepaper: Using New Technology to Meet the Challenges of Reducing Healthcare Bad Debt – There has never been a more critical time for US healthcare providers to ensure they follow guidelines of best practice when it comes to billing and payment.

[SLIDE PRESENTATION] Healthcare Debt Sales: Tips to Boost Revenue and Effectively Manage Patient Relationships – Selling medical debt can be a smart option that many hospitals overlook when thinking about how to manage their revenue cycle most effectively.