As the third-party billing process has evolved in the healthcare industry, patient collections are often treated as an afterthought.  Whether that’s due to a preconceived idea that asking for money face-to-face is difficult, or natural resistance to conflict, it’s widespread in hospitals and physician practices for billing staff to neglect or suspend the conversation entirely.

There are two significant reasons this is problematic:  1) patients have a right to be fully informed of their financial responsibility prior to receiving care, and 2) healthcare providers should be appropriately compensated for the care they provide.  Couple this with the fact that 69% of providers report seeing a significant increase in patient responsibility since 2017 due to insurance plan changes and the drift towards high deductible healthcare plans, and we see a rising collections problem adding to an already overburdened administrative system.

4 Benefits to be Realized

When presenting for care, patients and front office staff members often settle into a familiar scenario where each wants to minimize the perceived unpleasant task of discussing financial responsibilities.  Supplying administrative staff with automated estimation tools and training while setting provider-supported expectations ensures that this conversation is successful and sets an organization up to realize these benefits:

1.  Increased Patient Satisfaction

Healthcare providers have the opportunity at the beginning of any patient relationship to thoroughly educate patients and help them understand that they may have to pay a portion for their care.  Engaging the patient prior to their encounter allows both parties to discuss the details and options, leaving the patient with a more relaxed experience and virtually no surprise bills.

2.  Improved Revenue

Utilizing accurate automated estimations allows the provider to engage the patient early and collect the amounts due leading to less AR days outstanding and far less abandoned or reduced revenue being sent to collections.

3.  Reduced AR Rework

Today’s technology, including Artificial Intelligence (AI) driven software and machine learning, reduces the burdensome administrative process upfront, improves collections, and thereby reduces the after-the-fact collections efforts significantly.

4.  Better Planning and Forecasting Tools through Improved Analytics

With more accurate information comes improved analytics that helps in modeling future business plans, projecting growth and expansion, and negotiating third-party contracts.

Automated Improvements to Streamline Upfront Patient Collection Process

Failing to capture and verify accurate patient information is a problem that still pervades the healthcare industry and one that compounds the upfront patient collections process.  By incorporating state-of-the-art automated software that uses AI and machine learning, your organization will be able to provide a comprehensive financial picture when discussing, educating, and collecting estimated patient portions prior to service.

Prior Authorization Interactive software designed to process and follow-up on prior authorizations (PA) through an evolving, expanding interactive clearinghouse of payer information in real-time.

Insurance Verification and Benefits Eligibility — Verify and confirm precise benefits coverage details, including deductibles met and annual and lifetime maximums.

Patient Pay Estimations — Generate solid estimations that allow billing staff members to have educated and authoritative conversations with patients and either collect payment upfront or provide realistic payment options moving patients swiftly to the scheduling process.

With patients assuming more of the financial responsibility for their care, it’s critical to streamline the upfront collections process.  Through clear communication based on trusted and accurate estimations, patients are encouraged to take a proactive stance in paying for services and can rest assured that they are much less likely to receive surprise billing developing further trust with a hospital or provider practice.

Talk with us about improving your patient experience through upfront collections and patient pay estimation.