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Managing the “How Will You Pay For Your Visit Today?” Conversation

June 14, 2018

By David Shelton, CEO

Addressing this question just might be the most difficult conversation going on in the hospital today. It’s no secret that patient obligations are the fastest growing portion of hospital receivables, and the prominence of high-deductible plans means that most patients are effectively self-pay. Registration staffs and patients grapple with finding payment solution answers that can work for each patient in their current circumstances. 

Providing highly personalized financial solutions and guidance is a way for healthcare organizations to meet the “How will you pay?” challenge by balancing patient needs with hospital revenue goals. In practice, hospitals are playing catchup because their registration staffs and systems are often inconsistent with decentralized oversight, and numerous procedural workarounds that were never designed to operate effectively in this environment.

The impact on patients is often confusion or fear because of incorrect bill estimates and a lack of acceptable payment options to the point that patients may avoid care altogether. Creating a patient-friendly financial experience to fix the traditional registration and collections process isn’t merely a more efficient one-size-fits-all solution, and necessitates overcoming two primary hurdles:  

A Registration Challenge – The registration staff is typically the first point of contact with patients and sets the tone for the entire healthcare engagement. Many times, these front-line professionals are newer employees who may lack the experience to have these sensitive conversations, and are expected to collect increasing levels of patient revenue with methods or tools that don’t facilitate a scalable collections process, including: 

  • A lack of integrated workflow tools and timely information for effective communication with patients at the time of service. 
  • Registration staff members with limited experience in influencing patient collections with no view of patient’s current financial situation. 
  • An awkward and cumbersome collection process that delays the patient movement to their designated care area in the least amount of time.

A Patient Challenge – A common registration scenario is that patients rush through to get to their care destination without fully understanding their insurance coverage, how much they owe, over what time period, their options, and how they’ll ultimately pay for it. This traditional one-size-fits-all approach to payment plans fails to account for patients’ current financial situation. This standard approach to payment plans maximize collections over the shortest time period, and also lead to higher patient default rates and drive patients into bad debt status that also increase collection costs.  

The Solution – Rethinking the revenue cycle management systems from the top down and front to back, recognizing that patient registration and collections are usually the first and last points of contact with patients and frame their entire experience. With a holistic approach and best practices that integrate registration across departments, healthcare organizations can meet a double goal of enhancing the patient experience and improving the overall profitability. Best practices and strategies for transforming the revenue cycle include:

  • Integrating siloed business functions, including registration, billing, collections, and financial support. 
  • Coaching staff to engage with patients in this integrated way and treat them with compassion 
  • Providing accurate bill estimates so that patients know what to expect to pay, and when, before they arrive for care.
  • Customizing patient payment plans and expanding payment options and tools, including direct lending to patients.
  • Referencing individual propensity-to-pay data so that hospitals can better predict the best mix of services, payment options and financial support. 

Organizations that have embraced these principals are seeing significant and measurable business and patient engagement rewards, including improved collections, reduced lobby wait times and no-shows, reduced payment plan default rates and early out vendor expenses, and improved patient satisfaction. By transforming the patient financial experience, healthcare organizations deliver consumer-friendly patient financial services that reduce the stress of care, build community good will, and improve their bottom line.