With patient responsibility becoming an increasing part of clinics AR, you need to make sure you have an effective strategy in place. Learn how to maximize your collections without negatively impacting your relationships with your patients.
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Insights Webinar - Patient Payments
1. Patient Responsibility –
Solutions for Increasing Self Pay Collection Rates
Disclaimer: Nothing that we are sharing is intended as legally binding or prescriptive advice. This presentation is a
synthesis of publically available information and best practices.
2. Increasing Move to Self Pay
Financial responsibility for healthcare has shifted
to consumers, especially with the advent of the
ACA.
Patients now pay more healthcare costs than
employers.
This is leading to more cost sensitivity from
patients.
7. Questions? Tons.
Why did my PCP
refer me to that
specific
specialist?
Why did my PCP
prescribe me
that specific
medication?
Why did my
specialist refer
me to that
specific
radiologist?
Did I really have
to go to the
same lab twice?
How many
physicians in the
hospital actually
saw me and
billed me?
I wonder how
much this is all
going to cost
me….
I don’t
understand
how any of
this works!
8. Is This Information Being Published?
• Some patients might already be seeing how much
you charge or at least have access to that
information.
• Some patients might already have access to your
quality scores or other performance based
metrics.
• Medicare is shining lights all over different
partnerships in healthcare and how much
physicians have been paid.
• There are companies specifically dedicated to
showing all of this information.
10. Patients Are Now Consumers
Many consumers now shop around for the
best healthcare deals.
With HSAs, FSAs, and HRAs, people can now
manage for themselves how to pay for their
healthcare
11. Patient Enrollments
The proliferationof HDHPs means patients pay for a larger
portion of their care.
An estimated15% of patient enrollments comes from
HDHPs. Patient Enrollments
Other Payments
HDHPs
12. Who are these self paying people?
Have not met their deductibles
Have high copays or coinsurance
Lack health insurance coverage (in whole or part)
Require services not covered by their plans
Have exhausted their benefits
13. Why should we be concerned?
Patient Out of Pocket
Expenses
$250 billion - 2009
$450 billion – 2015
(expected)
= 68% increase
14. WHY SHOULD YOU BE CONCERNED?
Self paying patients made up more than 11% of
annual revenue in 2010.
Self payers default at the rate of about 30%.
81% of self pay revenues (by dollar) go
unrecovered.
Medical liabilities for self pay patients are
growing at 19% per year.
15. The Challenges
Strong pursuit of patient payment negative
message
Payment collections cost time and money
Insurers
More difficult
Automated process
Self-Payers
More expensive
Slower payments received
16. How Can You Get Your Payments?
Providers are loath to broach the subject of
patient financial responsibilities and
payment plans, but it has become a
necessity.
These days, the one size fits all payment
approach does not work.
18. Safely Store Credit Info
Store patients’ credit card information
securely in a certified system.
DO NOT keep a paper copy of any card
numbers.
19. Communicate Safeguards to the
Patient
Make sure you have the patient’s
permission to use the card for payment.
Use it as part of an easy-to-understand
financial policy form, complete with
explaining how the card will be used.
Have the patient sign the policy.
20. Estimate Costs and Collect Payment
Before Treatment
Plans are increasingly complex, so correctly
estimating costs is difficult.
Knowing when a patient has met a deductible
and/or copay is a challenge.
Patients may balk and choose another provider
whose costs are less expensive for the same
services.
21. The best solution is to collect patient
payment up front.
Once a patient goes out the door, your
chances of recouping full payment decrease
dramatically.
Staff accordingly – this takes time!
Collect Payment Up Front
22. Cash, checks, credit and debit cards, HSA
and FSA cards, etc.
Be very clear about what you will accept
and what you will not.
Offer Multiple Payment Options
23. Inform the patient before you charge
their card.
This will make patients feel more
comfortable keeping their card on file
and result in fewer disputes later.
Communicate Safeguards to the
Patient
25. Make it clear all bills are clearly marked as
patient responsibility. Patients receive so
many “This is not a bill” EOBs that they can
become confused.
Send Clear Bills
26. Follow up with a personal call. This one-to-
one contact produces better results than
paper collection notices.
Personalize Follow Up
27. - Patients are on the hook for more of their
health costs and are making decisions as
educated consumers using new tools. You
need to ensure the patients see the value
you provide.
- Tools such as “card on file” can, when
implemented correctly, help significantly
when the patient is ultimately responsible.
In Summary