Patient refunds from providers are on the rise.

Unfortunately, refund processes tend to be manual, complex and time-consuming for both providers and patients alike, with traditional paper-based methods no longer matching the needs of consumers.

As the number of patients paying out of pocket for healthcare services grows, refunds are taking on even greater importance. Patients often have multiple provider encounters that involve self-pay. Ensuring those dollars are posted accurately and appropriately is important in the provider's relationship with the patient and in the patient's overall journey and experience. 

While many providers attempt to collect balances due upfront to relieve the difficulty and stress of collections post-service, the estimates that are available ahead of service or at the time of service aren't always accurate based on which provider is paid first in the line of claim submissions.

Sue Martin, senior vice president of healthcare specialty services for CommerceHealthcare®, spoke about the burdensome nature of patient refunds.

"People must advocate for themselves," Martin said. "That means keeping up with appropriate insurance payments, as well as tracking where their self-pay dollars are being applied and where they may be entitled to refunds."

The traditional paper-based refund process has significant drawbacks. For providers, paper-based processes are inefficient, take more time and require additional labor. These antiquated processes are even more problematic as providers struggle with labor shortages and narrow margins in today's worsening economic climate.

Paper-based processes also are not ideal for patients, especially in an environment where so many consumers engage in online banking due to the convenience. It can be time-consuming to receive refund checks via the mail, and the traditional bank deposit process takes extra time. In addition, paper checks are prone to getting lost.

"We hear about these challenges on a regular basis from clients," Martin said, however, she offers a silver lining through modern technology. It's now possible to offer greater transparency about refunds to providers, payers and patients. CommerceHealthcare® offers its PreferPay® solution, for example, which is a secure, end-to-end automated refund process that integrates with provider solutions.

PreferPay® supports a variety of payment options including direct debit cards, direct deposit to a bank account and traditional paper checks. Offering multiple refund options is a huge step forward that improves providers' patient satisfaction scores.

"Consumers are looking for the same experience in healthcare as they have with their banking and shopping partners," Martin said. "Today, patients often have to wait for a paper refund check to arrive in the mail from their providers. With PreferPay®, they can get the funds owed to them in as little as 30 minutes."

Manual, paper-based systems commonly require multiple solutions and multiple departments to complete the entire patient refund process. Another major concern is the effort associated with escheatment of unclaimed funds.

Transitioning away from paper processes makes sense, but it's important to work with a trusted partner. "You want all the departments involved in the refund process to experience seamless workflows," Martin said. "CommerceHealthcare® works with providers to implement best practices and ultimately migrate to fully digital patient refund functionality."

A current-state review is a good first step on the transition to electronic patient refunds. Martin recommends tracking the costs surrounding check stock, printing and postage, as well as team member time spent processing the checks and following up, which should shed light on potential for return on investment.

Another best practice is to look for a partner and a solution that will work easily with the organization's treasury and receivables teams. Refunds routinely require processing from both accounts receivable and accounts payable for authorization and issuance of payments. These departments also need a workflow for tracking unclaimed payments.

In addition to processing patient refunds, PreferPay® can also streamline process flows that are critical to a strong employee value proposition.

"We've instituted workflows learned from other industries to drive better employee recruitment, retention and overall employee satisfaction," Martin said.

Automated payments also can be useful in areas like clinical trials and contract workers. "Take the automation and think bigger with it," Martin said. "You'll find it to be a true success."

"Implementing technology and automating refund processes that align with consumer preferences is absolutely a win-win for healthcare providers," Martin said. "Find a financial partner that offers a full suite of end-user and consumer satisfaction choices. If you make patients and your employees happy, you will find good success in the marketplace."

Sue Martin, Senior Vice President of healthcare specialty services for CommerceHealthcare®