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With the increase in consumer-directed healthcare, patient payments are becoming a more important part of healthcare provider revenue. However, as consumers, patients are accustomed to having a clear understanding of the amount owed prior to making a purchase.  Too often in the healthcare industry, patients are clueless about their payment responsibility until they receive a statement. And when patients are confused or uninformed, they are less likely to pay.

Faced with the challenge of collecting more patient payments, Canopy Partners, a management service organization, decided to calculate an estimate for patients prior to visits to collect more payments. However, its processes were manual and time-consuming, resulting in an administrative burden for its staff and its clients.  By automating eligibility verification and estimation, Canopy Partners was able to easily estimate patient responsibility prior to visits, set patient payment expectations and ultimately increase patient payments.

Automating Eligibility and Estimation


Canopy Partners staff would call payers or visit websites to check eligibility and then manually calculate the estimated patient responsibility using a spreadsheet. This process added hours of administrative work each week for the front office staff.


Canopy Partners implemented new technology to automate its estimation process with easily accessible eligibility information and pre-loaded fee schedules.  Without adding an administrative burden to staff, the automated process enabled Canopy Partners to verify patient eligibility prior to patient visits and create an estimate for patient responsibility in a matter of clicks.

Communicating Payment Responsibility Effectively


Once an estimate was generated, staff did not have a formal way to communicate the estimate to the patient, which is critical to setting payment expectations upfront.


Now, Canopy Partners automatically generates a letter to use prior to and during patient visits to formally communicate payment expectations. By notifying patients of their responsibility in writing, patients come to visits prepared to pay.  Additionally, with more knowledge around the amount owed, patients have a smoother payment experience.

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