Learn how to offset challenging self-pay patient account issues by improving collection and communication at all three stages of patient contact: pre-service, point-of-service, and post-service. Read more.
As businesses of all sizes struggle with skyrocketing healthcare costs, employers are looking to employees to help shoulder the burden, often by shifting to Consumer-Directed Health Plans (CDHP), which include higher medical deductibles and a higher share of payment responsibility for the employee. There’s one big problem with this approach, however: A significant number of patients can’t (or won’t) pay for healthcare without employer subsidies. Research indicates that consumers at all income levels are more likely to pay for their mortgages, insurance, loans, utilities, cable TV, Internet, lawn care, and newspapers before paying their healthcare bills. It’s a dangerous cycle for healthcare providers, health plan providers and consumers alike.
5. Set up and confirm payment plans
Technology and propensity-to-pay scoring systems should be used to create appropriate deposit and payment schedules. You can also take advantage of retail consumer strategies to collect payment, including:
Collecting deposits
Providing contracts that clearly set out payment schedules and expectations
Securely storing credit card information to improve future point-of-service collections
6. Collect payment
E-cashiering systems can post patient payments directly to the patient accounting system. Organizations that use these systems routinely report collection increases and AR reductions.
7. Advance your point-of-service policies beyond co-pay, fee schedule, and flat-rate collections
More complete, credible, and defensible estimates can help you expand collection activities while providing patients with a more precise understanding of their responsibilities. Again, this improves both collections and patient satisfaction.
Post-service
With most collections work already complete, post-service becomes the time to provide accuracy, consistency, and efficiency, with activities that include:
8. Confirm changes before billing
Plan enrollment, data collection, coverage limits, and dependent coverage are all subject to change unexpectedly, and constant enrollment changes in governmental plans like Medicare Advantage and Medicaid HMOs will only increase the likelihood of errors and rework. Double- check all of these to keep your final billing from hitting any snags.
9. Make your billing information and process clear and simple for patients, including:
- Easy-to-read statements that improve patient satisfaction and increase willingness to pay earlier in the revenue cycle.
- Consolidated family payment information to help the guarantor better manage his/her accounts overall.
- Consolidated bills from the lab, physician, and hospital, which make the bill easier to understand, therefore more likely to be paid.
- Offer online account management that reduces patient billing questions and phone calls, lowering costs, improving patient satisfaction, and accelerating post-service payment collection.
- Offer online payment plans, which lower self-pay AR and reduce processing costs by as much as $10 per transaction.
10. Improve collections efficiency
Obviously, it costs significantly less to collect from a large insurer with millions of patients than to collect from each individual patient. On average, consumers pay more than twice as slowly as all payers except Medicaid. This lag is why many providers find it more effective, efficient and profitable to outsource all self-pay accounts for maximum collection potential.
The Improvement Bonus: Performance Analysis
Improving self-pay strategies through all points of service clearly will deliver benefits. But a thorough performance analysis can take results to a new level. Drilling into self-pay data can help identify trends and better understand:
- Which patients are most likely to pay (for example, OB/GYN patients are most likely to pay given the need for repeat services)
- Which physicians bring the highest – and the lowest – yield patients
- Which ZIP codes’ patients tend to pay bills by the second statement
- Which referring doctors’ patients have the highest propensity to pay
Options and Opportunities
The rise in self-pay receivables is a significant issue for hospital financial performance. For many, receivables are growing faster than patient revenue. Estimating the cost of services before and at the point-of-service, as well as providing an efficient self-pay process can help make it significantly easier for patients to pay their outstanding balances.
At the same time, development and implementation of these essential functions and processes can be extremely time consuming, requiring more time than most hospital administration teams can afford to commit. The right outsourcing group should be able to support the process as an extension of your business office, with extensive knowledge of the keys to optimizing self-pay account resolution. With the right solution in place at every stage of patient contact, you will be able to achieve higher levels of patient satisfaction — and achieve faster recovery of payment. Add in the ability to identify and analyze important trends and you should be able to significantly improve performance, both immediately.
Change Healthcare can help you address these challenges and improve profitability with revenue cycle management services designed to help hospitals maintain their focus on patient care. Learn more about how Change Healthcare’s self-pay collection services can help optimize collections and shorten collection cycles.
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performanceinfo@mckesson.com
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