A group of senators introduced the “Health Care PRICE Transparency Act”in a move to empower patients to lower their healthcare costs.
On a basic level, the Act will require all medical facilities to post payer-negotiated rates for all shoppable services, so the patient can find the most inexpensive way to take care of their medical needs. This legislation will give Americans the chance to see the actual costs of their healthcare visits, which in theory, will increase competition and lower healthcare costs for everyone.
The added transparency of the Act will bring more accountability and competition to the healthcare industry, and gives American’s more control over their healthcare costs. However, if you are a medical practice, a hospital, or a member of the medical billing community, you need to know how you can best respond.
• “What is this procedure going to cost?”: There is going to be mounting pressure on practitioners, medical billers, and hospitals to have answers for the cost of procedures. Jeff Leibach, a director of Guidehouse’s healthcare strategic solutions team, says that “regardless of the legal fate of the final rule, hospitals need to be prepared for more price transparency in the future.” So, to get in front of this—and help you compete against your competitors—you should be prepared with both what it will cost for individual services and procedures, as well as, a ‘value statement’ on why it will cost what you are charging.
• Prepare to Comply or Cover the Costs: As it stands now, the legislation is moving towards technology assisting with the billing transparency. This will aid the patients to better understand the cost of services. This is a ‘clarion call’ for you to begin preparing for this reality or you will struggle with being fined and potentially publicly shamed in publications for being offenders. We recommend starting to comply NOW before the deadline ‘sneaks up’ on you.
• Use It To Improve: Currently, healthcare practices are, in many cases, already working at capacity. The added effort of defining cost and selling procedures are enough to make some healthcare facilities put this off until it is too late. Yet, while many may be considering accepting the fines and fees associated with non-compliance, we advise using this as an opportunity to improve—to better establish your medical practice’s services and promote your ability to be proactive to change. Getting ahead of the coming ‘wave’ of consumer expectations of healthcare will be a benefit.
• Seek Out Vendors That Can Assist: The changes that are coming for individual practices and healthcare providers can be overwhelming, and potentially it might just be more than what an IT team or private practice can handle. Forward-thinking billing departments should be investing in software vendors that can help fill that gap. EZClaim is a medical billing software company that partners with Trizetto to provide a tool called, Patient Responsibility Estimation(PRE). This tool assists in clarifying costs to consumers by providing a cheap and fast way for them to pay for out-of-pocket costs. [ Click here to learn more about how EZClaim can help you ].
It is clear that the expectations of consumers are changing, and the wave of medical transparency is on its way. Accepting it, preparing for it, and using vendor software to help overcome it, can be the difference of your practice avoiding fines and fees. For those forward-thinking and proactive practices who want to learn about how EZClaim can help, e-mail one of their sales representatives, go to their website for more details, or download a FREE 30-day trial today!
Educating patients about their payment options can improve your medical practice revenue.
Imagine for a moment that you are planning to buy a car. Before you even enter a car lot, you do some research on the type of car you need, the features you are looking for, and how much you are able to spend. You might even get an opinion from a friend or check out reviews online.
After you have gathered all the information you need, you feel you are ready to start shopping—and confident that you might even get some new keys by the end of the day.
This is very similar to how most business transactions work: They have a need, they research the best ways to meet their need, and they make a purchase.
However, the healthcare industry doesn’t follow this formula. Your medical practice is a business just like any other, but your customers—aka, patients—often seek out your services not knowing exactly what they will be “buying” from you, nor how much they will be paying. Add in health insurance and surprise bills and you have a confusing hodgepodge of information that calculates the patient’s final bill, which they likely will not see for several weeks.
The current system is inefficient, and it is part of the reason that up to 30% of patient bills go unpaid every year.
Changing the Patient’s Financial Experience Many practices have improved their revenue flow by simply treating their patients more like customers. In other words, they educate them on the financial side of things, as well as how to manage their health.
In a recent NexTrust webinar, three-quarters of poll respondents (doctors and practice managers) said that they speak to patients about their payment options. Thirty-one percent said that they currently use electronic communications, and only 8% use printed materials (flyers, signs, etc.).
While speaking to patients is a good start, getting payment information in writing is crucial to driving this information home. Patients already have a lot to remember regarding their care. A simple handout on how and when to make their payments can make it much easier for patients to manage their payment responsibility.
Most providers—over 90%—educate patients about how to pay on their statements. It certainly doesn’t hurt to communicate this information this way, but don’t rely on it exclusively. Most people skim the statement to see how much they owe and most miss important instructions.
So, as you educate patients on their payment options, keep these four key areas in mind to improve your medical practice revenue:
1) Set Clear Expectations about Payments
The first step in financially engaging your patients is to remind them you are a business, and that you require regular, on-time payments to keep your doors open. Patients often don’t see their doctors as business owners. A simple statement upfront about your payment expectations encourages patients to be more proactive about paying their bills on time.
2) Educate Patients about Your Payments Process
When patients understand your payments process, they are empowered to be more proactive in participating in it. You know where billing and payments fit into your practice workflow, so make sure patients understand that, too. If you require copays to be paid before a visit, communicate that beforehand so they can be prepared. In addition to that, also communicate clearly about when any remaining balances are due.
3) Push Your Online Payment Options
The best thing you can do to increase payments is to educate patients about their online payment options. Don’t just say “We accept payments online” and leave it at that. Show them where to go to complete payments. Also tell them about the variety of payment options available to them.
For example, EZClaim customers have several online payment options:
• Guest Pay: Patients can quickly pay their balance without having to set up an account
• MyProviderLink.com: If the patient wants access to more features (such as the ability to check their balance without having to call the office or to set up automatic payments), they can register for an account through BillFlash’s payment portal
• LinkPay: The practice sends a payment link to the patient before their visit, so they can pay what they owe before the visit starts
• PlanPay: Split up larger bills into smaller monthly payments
Online payments are the future of healthcare. So, make sure your online payment options are front and center whenever you bill patients. This could include a note in their statement directing them to pay online, handing out instruction cards on how to pay online, and posting signs throughout your office directing patients to your payment portal.
4) Reach Out to Patients You Haven’t Seen Lately
Forty percent of patients defer or skip care because they don’t think they can afford it. Make sure you get the word out to your entire patient base that you can accommodate any patient’s financial circumstances, whether that means setting up a payment plan or delaying payment for a few months. If patients know they have affordable payment options, they will be more likely to seek you out when they need help, rather than going somewhere else or deferring care entirely.
Empowering Patients to Take Ownership Over Their Healthcare Bills Most patients want to pay their medical bills promptly and in full, but being in the dark about what they are being charged for and what their payment options are makes that difficult. The patient financial experience matters, and when you educate your patients on their online payment options and are transparent about costs, they usually respond positively, and you will improve your medical practice revenue.
Credit card collections are a BIG part of any successful medical practice, and there has been a shift, in the last decade, that more insurance policies are adding co-pays with higher deductibles—which makes getting paid even more challenging.1 One industry report said that “73% of physicians shared that it typically takes at least one month to collect a payment, and 12% of their patients wait more than three months to pay.”2 With the current trend, more medical practices and their billing departments (or outsourced billing firms) are going the route of processing payment via credit cards, which has its PROS and CONS.
In light of this new information, the following are a few pros and cons for credit card processing that we anticipate in the near future and some insights for choosing the best billing software that supports the credit card processing needs of medical practices:
PRO: To protect against the dangers of stolen data, fraud, or other compromises in security, practices should seek out medical billing software that has credit card processing built-in, which can help safeguard against these dangers.
CON: Security is a big risk, and a leak in data leading to stolen funds can end up in a physician paying out-of-pocket for the breach. It is also important to note that breach of credit card data is also considered a violation under the federal Health Insurance Portability and Accountability Act (HIPAA).
PRO: Implementing credit card processing will reduce long waiting periods for payments from the majority of your patients, and will also reduce the additional effort your billing staff has to extend to collect on overdue notices.
CON: Practices cannot require patients to share their credit card information to receive medical care, and even if patients do share their credit card information, physicians cannot continue to charge the credit card without a patient’s consent.
PRO: Physicians can end the process of being a “line of credit” to unpaid or underpaid claims, and collect on funds immediately.
CON: You will need to implement internal processes that include, but are not limited to proper personal information storage and security, establishing guidelines on maximum percentages charged per bill, and personal consent forms.
Overall, there are definitely MORE ‘PROS’ than cons for implementing credit card processing for your medical practice, and all the trends are pointing to this being the PREFERRED METHOD of payment in the near future. EZClaim is proud to announce that it will release an integrated credit card processing solution, EZClaimPay, that is backed by a national merchant services vendor. [ EZClaim will be sharing more details about EZClaimPay in the weeks to come, via their social media platforms, their monthly newsletter, direct communications, and more ].
In addition to the credit card collections PROS and CONS above, we reached out to one of our partners, Live Compliance, to gather some regulatory and security advice. They suggested the following:
When accessing, transmitting, storing, or receiving any Protected Health Information (PHI), the Health and Human Services (HHS) Office of Civil Rights (OCR) mandates that you are to maintain HIPAA compliance.
When accepting, processing, or maintaining credit card information and debit card information, you must ensure that your organization is PCI DSS compliant (Payment Card Industry Data Security Standard).
In addition to the above Federal regulatory requirements, most states require privacy and security compliance requirements to be implemented, along with strict adherence to the privacy of Personally Identifiable Information (PII) and Breach Notification requirements.
For more information on your compliance requirements, visit Live Compliance for a Free Organization Assessment to identify and uncover your organization’s vulnerabilities.
If you are not a current customer of EZClaim, we would very much like to connect with you. You can either schedule a one-on-one consultation with our sales team, view a recorded demo, or download a FREE 30-day trial right now. For detailed product features or general information about EZClaim, visit our website at ezclaim.com.
[ NOTE: If you would like a quote on the upcoming merchant services, please e-mail firstname.lastname@example.org your last three merchant statements. For more on our ongoing updates and industry news, you can follow EZClaim on Facebook and LinkedIn ].
Source Material: 1 – America’s Health Insurance Plans” report that there were 20.2 million co-pays in 2017, which was up tremendously from just over 1 million in 2005. 2 – Source: From InstaMed’s annual “Trends in Healthcare Payments” report.
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