On January 13th we posted part one on this topic of Eligibility in healthcare, in that, we touched on deductibles, co-pay, and max out-of-pocket pay. Now in part two, we review the impact of price transparency in healthcare and its importance to the healthcare team decisions.
Consumers are the most important member of the healthcare team and are better collaborators in their care when they know all the variables and their required responsibilities in the process.
The individual consumer’s healthcare team includes, along with themselves, the physician and their staff, the pharmacist, an insurance adviser, and possibly some gatekeepers as well. The communication of clear symptoms when a patient is diagnosed is the responsibility of that team along with building an understanding of the financial responsibility that goes with any medical solution. While providing answers, options and solutions is a provider’s responsibility, so is providing a cost for the provided care. Therefore, price transparency can be achieved when the cost for that care is presented in a clear and concise fashion so the patient can understand what they owe, why they owe it, and when it is due.
Ensuring your staff is educated on discussing the financial responsibility with the patient from the first appointment and forward will strengthen the healthcare partnership and assist in the collection process. Understanding the steps that occur post the upfront estimate can be beneficial to the team. This discussion can be bolstered by ensuring bills are clearly marked with the statement, “this is a bill”, also clearly listing what the patient is being charged for when the bill is due and offering details on the methods of payment that are accepted. This clarifies what insurance will cover for the patient and their own out-of-pocket cost, prompting them to share any concerns and constraints with payments upfront.
Estimating patient responsibility is one part of the reimbursement process that is used for transparency for patient billing. The estimates can be provided using a spreadsheet of prior reimbursement and your most commonly billed CPT codes. If you would like an automated and more accurate option then look into a software tool like the Patient Responsibility Estimator by our solutions partner, TriZetto Provider Solutions (TPS). Giving this to the patient at the time of checking in will assure they have a rough idea of the costs and allow the office to collect upfront if needed.
For more information on how EZClaim can help you with this journey, schedule time with our sales team. Ready to get started? Download your FREE 30-day Trial today!
[ Contribution by Brenda Smelser with the DMC ]
As Patient Payment Responsibility continues to increase, sending patients to collections efficiently & effectively is more critical to the financial health of your practice than ever before. Here are some helpful tips to optimize your patient collections process.
- Communicate your collection policy upfront
- Integrate your collections process with your billing
- Consider offering discounts for self-pay patients
- Accept multiple forms of payment
- Offer multiple payment options
- Require patients to make “good faith” payments
Practices that employ the following practices can help prevent sending patients to collections or make the collections process much more efficient and effective.
1.Communicate your collection policy upfront
Prior to patient appointments, clearly communicate your collection policy. This helps the patient plan ahead to pay in full in the specified time period. This is especially important for patients that must meet a deductible or coinsurance amounts towards the out of pocket expenses. When patients are aware in advance, they are more likely to make some of their payment upfront. In addition to pre-visit communications, specify your collections with signs in your office, intake forms, information documents, and on your website.
2. Integrate your collections process with your billing
The current process to send patients to collections is tedious, time-consuming, and prone to error and miscommunications. That’s because staff must constantly and manually pull lists of patients eligible for collections and send all the necessary patient information to the agency. Plus, all the complex back and forth communications, followed by posting accounting for the payments.
Leveraging an automated patient billing system like BillFlash, you can create rules based on aging and minimums that queue up patients eligible for collections and send all the necessary information to begin the collections process. Practices can manage the entire collections process right in the patient billing system including setting rules, approving accounts for collections, and reports. To learn more, call NexTrust BillFlash at 435-940-9123 or visit collections.billflash.com
3. Consider offering discounts for self-pay patients
While insured patients receive discounts through their insurance provider, self-pay patients are responsible for their full payment. As an incentive to pay bills in a timely manner, offering self-pay patients a discount to pay in a timely fashion could reduce accounts sent to collections, improve the patient payment experience, and help improve your cash flow.
4. Accept Multiple Forms of Payment
Limitations in accepted payment methods and payment options can be a liability for your practice in getting paid quickly, and sometimes, getting paid at all. You can remove these barriers by incorporating payment systems that make it easy to accept all card types as well as payment plans. The BillFlash Billing and Payment system lets you offer these payment options to your patients simply. Patient billing and payments can then be synced with EZClaim because of the existing integration with BillFlash.
5. Offer Multiple Payment Options
Patients may find themselves in collections because out of pocket expenses are often much higher than they expected and can sometimes be thousands of dollars. Offering various payment methods and payment plans improves the patient experience and overall satisfaction.
Limitations in accepted payment methods and payment options can be a liability for your practice in getting paid quickly, and sometimes, getting paid at all. You can remove these barriers by incorporating payment systems that make it easy to accept all card types as well as payment plans. The BillFlash Billing and Payment system lets you offer these payment options to your patients simply. Patient billing and payments can then be streamlined because of the existing integration with BillFlash.
6. Require patients to make ‘good faith’ payments
If a patient is not paying their balance in full, requiring them to pay a portion of the payment is a helpful first step in keeping their commitment to fully meeting their financial responsibility. These small steps not only make the debt more manageable for patients but creates payment momentum for future payments so that at 90 or 120 days they owe much less and are less likely to be candidates for collections.
With increasingly more patient payment responsibility, the risk for patients being sent collections can rise as well. So, helping your patients avoid collections and optimizing your collections process when collections become necessary, can bring big financial returns
Call NexTrust today at 435-940-9123 or email at firstname.lastname@example.org or go to collections.billflash.com to learn how collections are now integrated with automated patient billing and payments to improve the financial health of your practice.
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