Tackling the brave new world of patient payments

The average per-person deductible has grown from $518 to $1,123 in the past 10 years — a 117 percent increase that represents a major shift in patient payment responsibility. While consumers may not think twice about an increase in everyday bills, many struggle with higher healthcare costs for a few reasons: difficulty making payment; adjusting to higher out-of-pocket costs; and not understanding the healthcare reimbursement system in general.

With nearly a third of a practice’s revenue coming from patients rather than insurers , it’s a new world for patients and providers alike. Thirty-two percent of a provider’s revenue now comes from a source that isn’t accustomed to making higher payments and might need encouragement with this adjustment.

That’s why our practice, Urology of Greater Atlanta, decided to evaluate our payment processes and determine how technology could enable a better collections model. Like many practices, we’ve seen a sharp increase in patients with high-deductible health plans — and we don’t want our practice’s financial health to suffer because we’ve left money on the table.

Automating collections processes
Before healthcare reform became a reality, our practice was already ahead of the curve on two different fronts: taking co-payments at time of service and offering recurring payment plans to help facilitate patient payment of larger amounts. But with such a high percentage of revenue coming from patients, we needed to do even more.

When one of our physicians asked about adding more flexible payment solutions, we saw the opportunity to make collections easier for both patients and staff. We implemented a new solution, Navicure Greenlight, which provides an integrated process for time-of-service collections, including co-pays, co-insurance and unmet deductibles, as well as automated payment plans. It allows staff to securely capture patients’ credit or debit card or even bank account information and then charge the card or account once we determine financial responsibility after claim adjudication.

Increasing efficiency while empowering patients
With new technology automating payments from start to finish, we revamped our processes to maximize efficiency and incorporate consumer-friendly practices. In the past, patients signed a form agreeing to pay the outlined estimate before scheduling surgery or a procedure. While we did try to collect some funds, they typically weren’t billed beyond their co-pay until we received claims payment. Now, we thoroughly review the patient’s financial responsibility prior to scheduling their procedure and collect a co-pay, full payment or partial payment. If patients don’t take care of their bills upfront, they are asked to enroll in the automated payment plan.

The automated payment plan has benefited both the practice and patients. Before, staff relied on the practice management system to generate a coupon book. Patients then manually mailed their monthly payments along with the coupon. Now, patients provide a debit/credit card number or bank draft information at enrollment, and their card or account is charged at predictable, pre-determined intervals. Patients can choose a three, six or 12-month plan depending on the amount of their bill. To help patients feel like they’re getting a good deal, we offer budget-friendly options such as "90 days same as cash."

In the past, people agreed to payment plans; however, the practice was left hoping they would follow through and mail in their payments. Now, with the automated payment process, we’re able to collect more with less work from our staff.

Recommendations for optimizing the collections model
Optimizing the patient collections model requires substantial behavior changes from both staff and patients. Even though technology can make many tasks easier for both parties, you still must get patients accustomed to paying up front and continuing to pay until their bill is settled. In turn, staff must be comfortable with communicating new policies and asking for payment. Our team credits the following best practices for enabling our success:

  • Secure buy-in. Physicians can have varying attitudes about patient payment. Get everyone in the practice in agreement, using examples from other practices in your local market or beyond.
  • Stay proactive. The move to time-of-service collections is necessary, but it requires a shift in culture and processes. Make sure your staff is trained and comfortable being proactive and asking for payment up front.
  • Be transparent. Providing patients an accurate written estimate can give you more credibility — and remove any surprises about costs and fees down the road. Having your estimator tool work in tandem with your patient collections tool can facilitate the financial discussion as your staff asks for payment. It also avoids large volumes of patient refunds.

Patients are just getting accustomed to higher deductibles and medical bills. Your practice’s financial survival depends on your ability to help them understand their financial responsibility, provide easy payment methods, and above all, proactively collect payment. Along the way, you’ll not only increase collections but improve their experience, too.

Cheris Craig is chief administrative officer at Urology of Greater Atlanta.

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