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Payments Made Clear; Payments Made Quick™ HealthCare Payment Solutions Patient Friendly Payment Solutions.

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Presentation on theme: "Payments Made Clear; Payments Made Quick™ HealthCare Payment Solutions Patient Friendly Payment Solutions."— Presentation transcript:

1 Payments Made Clear; Payments Made Quick™ HealthCare Payment Solutions Patient Friendly Payment Solutions

2 Payments Made Clear; Payments Made Quick™ Agenda 1.Overview – What is Prefunding 2.New Patient Field Requirements 3.Setting Up A Prefunding Plan 4.System Demo 5.Prefunding Plan Changes/Modifications 6.Money Movement 7.Reporting 8.Provider Obligations 9.Disputes Overview 10.Prefunding Your Existing Receivables

3 Payments Made Clear; Payments Made Quick™ What is Prefunding? A contract between you and the lender on a payment plan established between you and a patient – Receivables Funding Agreement – Not Between the Lender and the Patient Prefunded – ACH 7-10 days No Credit Check – Everyone Qualifies (two forms of payment and a valid ID) Non-recourse to the Provider – “We’re the bank!” – Must complete care; must make 2 successful scheduled payments The larger the down payment and the shorter the term, the more you get paid

4 Payments Made Clear; Payments Made Quick™ Patient Prefunding Highlights Patient must have two forms of payments – Checking Account (preferred) – Credit Card (secondary) – Cannot be a Debit Card AND a Checking Account Patient must have a valid form of ID – Drivers license – State Issued ID Patient must sign and agree to itemized prescribed care plan

5 Payments Made Clear; Payments Made Quick™ Prefunding Plan Requirements Minimum Prefunding Amount per Plan = $1000 Maximum Prefunding Amount per Plan = $5000 Minimum % Down – 0 to 12 Months, 0% down – 13 to 24 Months, 10% down * These are subject to change based on lender requirements

6 Payments Made Clear; Payments Made Quick™ Patient Field Requirements Full Address Phone Number (1 required, 2 recommended) E Mail (Recommended) Drivers License State and Number/State Issued ID Social Security Number – This IS NOT used for a credit check – This is required if the patient defaults and hard collections is pursued 2 Payment Funding Sources Patients will be automatically enrolled in e mail messaging

7 Payments Made Clear; Payments Made Quick™ Plan Set Up – High Level Available for AR Plans Only – New AR Plan Options for Encounter Details and Encounter Summary Build Out Care Plan Select Prefunding Options – 4 Predefined Prefunding Options 6 months, 10% Down 12 months, 15% Down 18 months, 20% Down 24 months, 30% Down – Promo Matcher Match based on what Patient can afford Provider T&C Agreement Patient Plan Agreement

8 Payments Made Clear; Payments Made Quick™ Step 1 – Build Out a Care Plan System will now allow you to build out a care plan by entering encounter details You can still enter encounter summary

9 Payments Made Clear; Payments Made Quick™ Step 2 – Plan Selection Once Care Plan is built out, you can offer patients the traditional payment plan or the new Prefunding Option

10 Payments Made Clear; Payments Made Quick™ Step 3 – Finance Options Pick a program that’s convenient to youLet the Patient Decide *Still must meet criteria for Minimum

11 Payments Made Clear; Payments Made Quick™ Step 4 – Funding Sources Add Payment Funding Sources

12 Payments Made Clear; Payments Made Quick™ Step 5 – Patient Agreement Must maintain a signed copy of the care plan This will be requested from you in cases of patient disputes Patient must sign and initial in all places New Format

13 Payments Made Clear; Payments Made Quick™ New Care Plan Agreement – Page 1

14 Payments Made Clear; Payments Made Quick™ New Care Plan Agreement – Page 2

15 Payments Made Clear; Payments Made Quick™ Step 6 – Provider Contract User Agrees to Service Agreement Terms and Conditions, Funding Services Agreement and Receivable Funding Agreement E mail sent to primary provider contact on account

16 Payments Made Clear; Payments Made Quick™ Additional Required Fields Contracts cannot be submitted without additional fields required by the lender User will be prompted to complete all required fields

17 Payments Made Clear; Payments Made Quick™ System Demo

18 Payments Made Clear; Payments Made Quick™ Modifications to Prefunding Plans Providers can only perform the following functions – Adjust Balances Upward This will result in a request for additional prefunding To be eligible, there cannot be any history of declines/rejects on the plan Assumes zero down on additional funding requested – Adjust Balance Down Typically used if care plan is canceled early by patient This will result in a refund of prefund dollars to the lender – Change funding sources Only ClearGage Help Desk and Admin Services Team Members can make the following changes to a prefund plan – Payment Amount – Payment Frequency – Status (Suspended/cancelled/closed)

19 Payments Made Clear; Payments Made Quick™ Adjustment Examples Negative Adjustment – Starting Plan Balance =$1000.00 – Prefunded at 80% = $800.00 – Plan Balance Adjusted Down = - $500.00 – Prefund Refund Owed to Lender = $400.00

20 Payments Made Clear; Payments Made Quick™ Adjustment Examples Positive Adjustment – Starting Plan Balance $1000.00 – Down Payment $200.00 – Prefunded at 80% $800.00 – Plan Balance Adjusted Up $1000.00 – New Patient Starting Balance $2000.00 – Original Down Payment $200.00 – Recalculate Prefunding @ 75% $1500.00 – Additional Prefunding Owed Provider $700.00 $1500 New - $800 Already Paid

21 Payments Made Clear; Payments Made Quick™ Money Flow

22 Payments Made Clear; Payments Made Quick™ Money Flow Notes New Plans are submitted to the lender after 8 days ACH of prefunding dollars is sent directly to provider (7-10 Business days) Payment Plan Transactions are deposited daily to your account ClearGage will sweep eligible payment plan transactions from your account on the date funds are deposited in your account The daily activity to/from your account will be based on the following formula: Payment Plan Transactions collected by your office - patient transactions that have rejected after we have swept the transaction from you Example: 10 Transactions Owed to Lender @ $100 Each $ 1000 1 Rejected Transaction already swept @ $250- $ 250 Total Sweep Amount $ 750

23 Payments Made Clear; Payments Made Quick™ Money Flow Notes - Continued If a Patient transaction rejects after we have swept it and there is no offsetting transaction to pull from you, an ACH will be initiated the day you are notified of the reject from Sage There will be a daily prefund reconciliation report that will provide a detailed list of transactions/credits and adjustments being ACH’d from/to your account Rejected Client Sweep Transactions – Funding will be suspended until transaction is resolved

24 Payments Made Clear; Payments Made Quick™ Prefund Reconciliation Summary Prefund Reconciliation Detail DateAmount DatePatientAmountTransaction Type 1-Aug-$1,000.00 2-AugSusie Smith-$300.00Repayment 2-Aug-$100.00 2-AugSarah Renolds$200.00Reject Repayment 3-Aug-$750.00 Total-$100.00 4-Aug$200.00 5-Aug-$350.00 6-Aug-$1,000.00 DatePatientAmountTransaction Type 7-Aug-$650.00 4-AugRob Kelsy$200.00Reject Repayment 8-Aug-$300.00 Total$200.00 Reporting Daily Prefunding Sweep Reconciliation Report

25 Payments Made Clear; Payments Made Quick™ Lender Reconciliation Report DateAmountDatePatient NameReasonContract DatePlan AmtFunding AmtFunding % 1-Aug$2,150.001-AugSusie SmithNew Contract22-Jul1,500.001,190.0079% 1-Aug($550.00)1-AugJack JohnsonNew Contract22-Jul1,315.07960.0073% 2-Aug$1,500.00 3-Aug$1,250.00DatePatient NameReasonContract DatePlan AmtFunding Amt 4-Aug$3,200.001-AugLisa Lou Plan Adjustment31-Jul(800.00)(550.00) 5-Aug$1,315.00 6-Aug$1,025.00 7-Aug$3,252.00 8-Aug$1,750.00 Reporting Daily Lender Reconciliation Report – ACH for New Contracts – ACH for Adjustments (+/-)

26 Payments Made Clear; Payments Made Quick™ Provider Obligations Maintain Accurate Patient Information in Payment Accelerator – Phone Numbers, E Mail, etc Maintain Accurate Balances in ClearGage – Negative adjustments for care not delivered – Post all cash/manual Payments against correct plan balances Respond to Patient Dispute Requests – Resolve patient disputes prior to escalation to ClearGage – Respond to all requests from ClearGage within 10 business days – Maintain accurate records/notes – Document all discussions in the Payment Accelerator Patient Reject Assistance – Support ClearGage Admin Services team if we need assistance with a patient – It is in your best interest to minimize default rates for the lender – to maintain good status

27 Payments Made Clear; Payments Made Quick™ Disputes Overview ClearGage will notify provider of disputes via e mail Provider should respond to all “RCI”s (Request for Case Information) within 10 business days ClearGage Dispute Department will review all documentation (Care Plan/Patient Statements/Case Notes) and respond to all parties within 10 business days of receipt of RCI, with a Dispute Status Notification – In cases where care has been rendered, the patient will be responsible for plan balance – In cases where services have not been rendered, care plan balances will be adjusted to reflect actual care/services rendered and provider will refund lender on prefund overpayments. Failure to respond to disputed plans within 10 business days will result in full prefund revocation of care plan

28 Payments Made Clear; Payments Made Quick™ Prefunding your Existing Receivables Plans are eligible if they meet the following criteria – Must have made at least 2 successful payments – No history of declines or rejects – Not more than $5000 balance – Not Less than 3 months and not more than 15 months remaining term Must sell all of your existing receivables – Cannot pick and choose

29 Payments Made Clear; Payments Made Quick™ Receivable Funding Existing patient funding available at your finger tips

30 Payments Made Clear; Payments Made Quick™ Receivable Funding You must update required patient information before submitting your receivables file

31 Payments Made Clear; Payments Made Quick™ Receivable Funding Once all eligible receivables are updated with correct patient information, you can submit all receivables for prefunding


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