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Patient Billing And Collections Process Needs A Tune-Up

Posted on October 1, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study from a patient payments vendor suggests that many healthcare organizations haven’t optimized their patient billing and collections process, a vulnerability which has persisted despite their efforts to crack the problem.

The survey found that while the entire billing collections process was flawed, respondents said that collecting patient payments was the toughest problem, followed by the need to deploy better tools and technologies.

Another issue was the nature of their collections efforts. Sixty percent of responding organizations use collections agencies, an approach which can establish an adversarial relationship between patient and provider and perhaps drive consumers elsewhere.

Yet another concern was long delays in issuing bills to patients. The survey found that 65% of organizations average more than 60 days to collect patient payments, and 40% waited on payments for more than 90 days.

These results align other studies that look at patient payments, all of which echo the notion that the patient collection process is far from what it should be.

For example, a study by payment services vendor InstaMed found that more than 90% of consumers would like to know what the payment responsibility is prior to a provider visit. Worse, very few consumers even know what the deductible, co-insurance and out-of-pocket maximums are, making it more likely that the will be hit with a bill they can’t afford.

As with the Cedar study, InstaMed’s research found that providers are waiting a long time to collect patient payments, three-quarters of organizations waiting a month to close out patient balances.

Not only that, investments in revenue cycle management technology aren’t necessarily enough to kickstart patient payment volumes. A survey done last year by the Healthcare Financial Management Association and vendor Navigant found that while three-quarters of hospitals said that their RCM technology budget was increasing, they weren’t necessarily getting the ROI they’d hoped to see.

According to the survey, 77% of hospitals less than 100 beds and 78% of hospitals with 100 to 500 beds planned to increase their RCM spending. Their areas of investment included business intelligence analytics, EHR-enabled workflow or reporting, revenue integrity, coding and physician/clinician documentation options.

Still, process improvements seem to have had a bigger payoff. These hospitals are placing a lot of faith in revenue integrity programs, with 22% saying that revenue integrity was a top RCM focus area for this year. Those who would already put such a program in place said that it offered significant benefits, including increased net collections (68%), greater charge capture (61%) and reduced compliance risks (61%).

As I see it, the key takeaways here are that making sure patients know what to expect financially and putting programs in place to improve internal processes can have a big impact on patient payments. Still, with consumers financing a lot of their care these days, getting their dollars in the door should continue to be an issue. After all, you can’t get blood from a stone.

Healthcare Execs Want To Collect More From Patients

Posted on May 26, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Every healthcare provider wants to get paid, of course. However, collecting the ever-growing portion of revenue that patients owe is tough, and getting tougher. That being said, the majority of providers recognize that they have a big problem and are working to boost the volume and speed of patient payments, a new study finds.

The study, which is sponsored by claims management and patient payments vendor Navicure in affiliation with Porter Research, connected with 300 of professionals, including practice administrators (36%), C-suite executives (25%) and billing managers (35%). Forty-one percent of organizations had 1 to 10 providers, 31% had 11 to 50 providers, 12% had 51 to 100 providers and 17% had more than 100 providers.

In responding to the survey, 63% of survey respondents said that patient payment processes were a high priority for their leadership teams. Their challenges in collecting from patients included patients’ inability to pay (31%), difficulty educating patients about the financial responsibility (26%) and slow-paying patients (25%).

It’s not surprising that collecting patient payments is a priority for many organizations. The study found that patient payment revenue made up 11% to 20% of total revenue for almost a third of organizations that responded. Twenty percent of organizations said patient payments accounted for 21% to 30% of total revenue, and for 23%, patient payments accounted for more than 31% of total revenue.

More than half (57%) of respondents said they educate patients about their financial responsibility, but only 42% said they always estimate the patient’s cost at the time of service. What’s more, few have implemented steps that might streamline payment. Sixty-two percent do not offer credit card on file programs, 52% don’t have automated payment plans in place, and 57% don’t send electronic statements to patients.

To address these issues, Navicure recommends that providers make several changes in their patient payment processes. These include viewing patients’ eligibility information prior to or at the time of service, collecting copays and outstanding balances, creating care estimates and enrolling patients in any available payment plans.

While the survey doesn’t address this issue directly, it also doesn’t hurt to make bills more readable. I’ve read accounts of some hospital billing departments and medical office staffers spending hours on the phone with patients going over charges. Not only does this frustrate the patients, and undermine their relationship with your organization, it wastes a lot of time. Cleaning up bill formats can go a long way toward smoothing out routine payment issues.

On that note, it probably makes sense to roll out patient-friendly billing technologies. More than 70% of respondents who have replaced paper statements with online bill payment and e-statements would recommend this technology to a peer, and 42% of respondents using automated payment plans were very or completely satisfied.

Ultimately, however, collecting more from patients probably calls for changes in policy, the research suggests. While 35% ask for a partial deposit before service, and 26% collect all of what a patient owes before service, 18% of respondents said they didn’t collect anything before prior to service, and 21% said they didn’t charge until claims were processed.