Today, providers need to place more emphasis on collection from patient balances since there is more financial responsibility from insured patients. This is a direct result from high dollar deductible health plans associated with health saving accounts or tax-advantaged medical savings accounts.
Successful patient collection strategies revolve around the basic concept of better communication and education of medical debt owed. These patient collection strategies should recognize that it costs two to three times as much to collect from patients as it does to collect from payers. As such, practices should avoid costly programs that result in ineffective statements and calls that don’t pay off.
In today’s environment, the patient collection strategies must look beyond the traditional passive approach to derive monies from the patient or guarantor. Within a program design the strategies include:
The most effective time to collection monies to meet the financial responsibility of the patient is at the time of service. The registration staff needs to have the knowledge and skill to understand and communicate to the patient the amount due for the services rendered. Registration staff should go above and beyond taking patient demographic information but also understand and communicate the financial responsibility of the patient based on the services rendered. (Note, the providers and practices that implement POS collections are more successful when the provider performs the registration).
Well-designed patient statements and information sent to the patient/guarantor need to effectively convey the balance due for medical services. The optics of an effective statement should easily inform the patient not only of the balance due, but also, the pertinent information regarding the provider of services, services performed, charges of services, payer payments and adjustments, as well as contact name, address and telephone number for statement inquiries. Many statements out there do not provide the patient with enough information to understand the charges they are being asked to pay. You will have a higher chance of getting a patient to respond, if they understand how they relate to the services performed.
Patient follow-up programs go beyond the traditional written communication; they include action steps to proactively reach out to the patient/guarantor. The more successful programs prioritize patient follow up based on an algorithm of elements that score the patient to determine their propensity to pay; thus determining where follow-up efforts should be focused. For standard practice, these follow-ups typically should happen once a month through phone calls and emails.
The ability to offer patients the option to make time-based payments or discounted amounts in many cases will motivate the responsible party to resolve medical debt which otherwise would go unpaid. This is particularly important when working with uninsured or underinsured patients. Most of the time, a time-based arrangements are created through a structured plan when the patients call to inquire about their account. The provider’s payment arrangement policy is generally disclosed at the time the service is rendered and through other written and verbal communications.
The ability to pay bills via some form of online payment portal is an acceptable practice and quickly becoming a preferred practice. Offering payment options as part of a payment portal and using current technology is appealing to all patients, but especially, to younger generations. Like the patient statements, it is important to have well designed online patient portals that provide the patient with detailed information regarding the nature of their bill. Another important point to note here is the importance of using a patient portal that meets the highest standards of security, to ensure the protection of your patient’s information and to meet HIPAA compliance requirements.
It is important to provide personnel with necessary skills to deal with nuances of patient inquiries. The patient representative’s challenge is to go beyond basic inquiry scripts but to truly assist and educate the patient in understanding their financial responsibility. The necessary skills to provide personnel with vary between both training and experience. Personnel should be familiar with medical insurance reimbursements, as well as, the provider financial policies. Statistically speaking, two-thirds of calls are related to inquiries about their bill and insurance coverage. It is vital that the patient representative is communicating what services were rendered while looking at the account and why the patient is responsible for the charges incurred.
For each major facet of a Patient Collection Plan, there should be metrics or key performance indicators developed to periodically monitor the success of the various patient collection strategies and to make adjustments in order to build upon with the goal to improve patient collections.
Medical practices are relying on ever increasing patient responsibilities collections to maintain or achieve acceptable practice revenues. In today’s environment, revenue cycle management requires focusing on patient collection strategies to maximize cash collections as well as provide a positive patient experience.
Randy Keller is the executive vice president of operations at Intermedix. Randy offers more than 20 years of experience generating financial growth and supporting efficient operations within the healthcare industry. A CPA and executive with a proven track record of developing, directing, and implementing initiatives to establish and achieve business goals. Randy obtained his bachelor of science degree in accounting at University of North Carolina at Charlotte.