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Six Benefits and Results of Having a Good Credit Balance Resolution Program


In today’s healthcare environment, credit balances are commonplace. The healthcare industry has a high incidence of credit balances due to multiple parties paying claims. The way that various information technology (IT) systems operate also creates credit balances.

Each provider must determine its credit balance strategy — implement an internal program, which usually requires adding staff; outsourcing this work; or ignoring it. This last option is not optimal or realistic, given penalties for failure to comply with regulations on both the state and federal levels can be significant.

The common result is that healthcare providers do not want to add staff, if it can be avoided, and credit balance resolution provides a substantive distraction from the staff’s primary billing and collection focus. Among the reasons for this, is the provider belief that it’s painful to pay staff members to “give money away.” And, once behind in their credit balance resolution work, it is very difficult to catch up.

This leaves as the best alternative for handling credit balance resolutions – outsourcing! Following are the six top benefits and results for outsourcing your credit balance work:

Six Credit Balance Benefits:

1.   Significantly reduces staff time spent on credit balances

2.   Allows staff to focus on billing and collection activities

3.   You can accurately quantify your cash exposure

4.   Reduces interest costs for patient refunds

5.   Provides regulatory and Sarbanes-Oxley compliance

6.   Cost-effective to implement and use

Six Credit Balance Solution Benefits:

1.   Significantly reduces overall credit balances

2.   Increases staff productivity

3.   Resolves more credit balances with same number of staff

4.   Fewer payer and patient inquiries

5.   Better compliance with payer contract terms

6.   Escheat (uncashed payment checks) compliance

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