Hayes' Healthcare Blog

Paul Fox

Recent Posts

Non-Medicare Payer Contracts and High Deductible Health Plans: 5 Things to Consider

Posted by Paul Fox on May 10, 2017 at 9:00 AM

Many non-Medicare provider contracts have unwritten ramifications of which you should be aware.  In today’s world of High Deductible Health Plans (HDHP) what you are really negotiating is your future self-pay liability until your patient’s deductible has been satisfied.  Do you have a viable strategy in place to understand what your organization’s options are and what you can/cannot do under your payer contract terms?  Additionally, should you insist certain clauses be present in the contract which will empower your facility to accurately collect at the time of service?

Here are five things to consider before entering into an agreement with a payer.

Read More

Topics: high deductible health plans, Healthcare insurance

7 Ways to Plug High Deductible Health Plan Revenue Leaks

Posted by Paul Fox on August 3, 2016 at 9:00 AM

According to a recent report, three out of four employers now offer high deductible health insurance plans, up from just over two out
 of four five years ago.  At 22 percent of employers, it’s now the only option and nearly half of employers plan to make high deductible plans the only choice by 2018.[1]

high-deductible health plan (HDHP) is a health insurance plan with lower premiums and higher patient deductibles than a traditional plan. Choosing an HDHP is required if an individual wants to take advantage of the tax benefits of a health savings account (HSA/FSA). HDHP’s make employees personally responsible for a higher portion of their family’s healthcare costs, with the goal of motivating them to comparison-shop for medical services.

With an HDHP, consumers pay for all their medical services — at the insurer’s negotiated rate — until they meet their deductible. After that, consumers typically are responsible for a co-pay, normally 10 to 35 percent of the service — until they reach their out-of-pocket maximum. If payment isn’t collected at the time of service, the provider is left having to bill the patient for the remaining self-pay balances after a normal 20-40-day adjudication period. Most studies suggest the longer the self-pay account goes unpaid, the less likely it becomes that the provider will ever collect.

Can your organization survive under those financial terms? Most would answer an emphatic “no!”

There’s no question that HDHP’s are adding financial stress to healthcare organizations. Here are seven strategies you can use to help prevent revenue loss as a result of the growing use of HDHP’s.

Read More

Topics: high deductible health plans, revenue cycle management, Healthcare insurance

4 Ways to Improve Your End User System Testing

Posted by Paul Fox on February 18, 2015 at 9:00 AM

It seems that every install that I have been a part of for the past 25 years goes by the policy that the best way to test a new system is to have the same individuals on the build team to also be the testers. On its own merits, it may sound logical, but in practicality, it can be a regrettable business decision. But the question remains, is this the most effective and efficient process?

The subtle differences that I have learned along the way that fall between “efficient" and "effective" comes into play with system testing of any kind.

Read More

Topics: training end users, system testing

Want more from Hayes?

5 Cool Things in Healthcare

Sign up for our weekly 5 Cool Things in Healthcare newsletter.  Every Friday we give you five stories of innovation, disruption, and - you guessed it - coolness. 

Here's how:

Subscribe to Email Updates

Posts by Topic

see all