RPM Billing LLC Creates Customized ‘Patient Estimator Tool’ to Help Clients Estimate Patient Responsibility at Point of Service


We are proud to provide our clients with the RPM Billing Patient Estimator Tool, which allows provider scheduling and check-in staff to easily and accurately estimate the amount of patient responsibility for each service so that it can be collected at the point of service. Estimating patient responsibility and performing upfront collections is a significant challenge for most healthcare providers. There are numerous variables and complicating factors, and the result is a formula so complicated and unreliable that many healthcare providers just avoid upfront collections efforts. However, with patient deductibles and co-pays increasing to new heights, patients are now responsible for up to 25-40% of the allowed payment amount from their insurance company. Providers who routinely leave this money on the table are seeing their margins disappear while insurance revenues shrink.  

The ROI on this tool is incredible.  With just a few clicks, providers and their office staff can finally have confidence when asking for the patient portion of the payment at time of service or scheduling.
— Jonathan Marshall, MBA, President of RPM Billing LLC.

Industry experts and provider surveys report that many providers struggle with accurate upfront collections for each service, and are failing at this critical step of the revenue cycle (https://www.beckershospitalreview.com/finance/10-things-to-know-about-healthcare-collections-patient-financial-responsibility.html). Providers who don’t collect upfront spend time and money chasing patient payments for months and years after services are provided. That is an expensive, unreliable, and unwanted process. The “80/20 rule” on upfront collections is that 80% of it can be collected in person at time of service at almost no cost to the provider, while only 20% of it gets collected if you wait until after the service is provided, and that comes at a high cost. 

Also, studies show that patient experience scores improve when there is clear communication about the estimated cost to the patient. In our experience, the majority of patients prefer to have an opportunity to pay their part or set up a payment plan in person as opposed to receiving annoying phone calls and statements for months following the service. The RPM Billing Patient Estimator Tool allows providers to ask for an accurate amount of patient payment at time of scheduling or service.

RPM Billing LLC has been working with providers to create a customized ‘Estimator Tool’ that front desk and scheduling staff use when working with patients. We first spend time working with providers and office leadership to gain a complete understanding of the business and services provided and the patients served. We then spend time designing the RPM Billing Patient Estimator Tool to fit the business. Finally, we work with providers and office leadership to design the processes around how it will seamlessly fit into the flow of the provider’s existing scheduling, check-in, and upfront collections processes. 

The RPM Billing Patient Estimator Tool takes into consideration all of these factors and provides an accurate estimate of the patient liability in just a few clicks:

-          Expected CPT codes and their charges for all service lines

-          Services that require multiple CPT codes

-          Insurance contracted reimbursement amounts on all CPT codes

-          Patient co-pay and co-insurance

-          Covered services and ABNs

-          Patient and family deductibles, and how much has been met so far

-          Patient and family out of pocket maximum, and how much has been met so far

Additionally, the RPM Billing Patient Estimator Tool is set up to provide selected users (leaders, billers) with a password-protected separate snapshot of each patient which includes a complete estimate of the charges, insurance allowable, insurance payment, and patient payment.  These snapshot reports can be used for analysis and productivity reporting, and it can also be compared to the EOBs on each claim.  With this comparison we can create a feedback loop that helps us ensure accuracy for our clients by modifying and evolving the Estimator Tool based on the comparison of the estimate to the EOB.

“The ROI on this tool is incredible.  With just a few clicks, providers and their office staff can finally have confidence when asking for the patient portion of the payment at time of service or scheduling,” says Jonathan Marshall, President of RPM Billing LLC.  “We are very excited to offer this service as yet another way we are helping our hard working clients get paid appropriately and timely for all of the services they provide.”

RPM Billing LLC is a medical billing and consulting firm based in Las Vegas and Reno, Nevada, serving doctors, hospitals, surgery centers, rehab centers, ambulance providers, and other healthcare providers nationwide. We have an experienced billing team, and we work closely with our clients to make sure 100% of their bills get paid appropriately and timely. Led by Jonathan Marshall, who holds a Healthcare MBA and two decades of experience as CEO, CFO, and COO of hospitals and physician practices, RPM Billing was created as the answer to all of the overpriced and underperforming billing offices out there. We are 100% committed to excellent service, processes, bottom line results, and ethics. To contact us for a free review of your company’s opportunities to improve revenues, please call us at 775-501-9820, email us at jon@rpmbilling.com, or visit us at www.rpmbilling.com. Thank you.