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Many healthcare providers are concerned about the impact to their businesses that will result under PPACA.  Much of this concern is due to the additional 20 to 30 million uninsured Americans that will begin to receive new healthcare coverage in 2014.  With more patients eligible to receive healthcare services, and hundreds of millions of patient payments transactions being added to the U.S. healthcare system, the difficulties providers face with patient collections is becoming a high priority issue.

Shifting the focus to patient collections is a challenge for many providers, as they previously relied almost exclusively on payer payments for their revenue.  A simple Google search will deliver countless ideas on how to collect more from patients, especially those with high deductibles.  However, when it comes to maintaining and increasing your revenue, it’s crucial to understand the misconceptions versus the best practices you should follow.

Below are a few of the most common misconceptions about collecting patient payments, with a to-do list to help you achieve payment assurance.

Misconception #1: Discussing payment during the patient visit is taboo.

  • Traditionally, staff do not like to discuss payment with patients because these discussions may be uncomfortable, and they want to focus on patient satisfaction.  However, patient satisfaction is derived from their expectations with regard to both clinical outcomes and payment responsibilities. If patients do not understand or even have an expectation of how much they may owe, how they will be billed and how they can pay, they are more likely to be confused.  This can lead to negative patient satisfaction irrespective of their clinical outcomes.

To do: Train staff to inform patients, prior to the patient visit or at the point of service, that they will be expected to pay for all patient responsibility, including co-pays, deductibles and co-insurance.  Create a script that includes details of your billing process and the patient payment options you offer.  This will make these interactions easier for your staff, and patients will be happy to have expectations and more clarity around the payment process.

Misconception #2: Communicating with the patient about the amount owed is impossible to do during the patient visit.

  • During the patient’s visit, you may not be able to tell your patients the exact amount they will owe in deductibles and co-insurance; however, you can offer an estimate to begin to set expectations.

To do: Verify all patients’ eligibility and perform a payment estimate for each patient, either in batch prior to the visit or in real-time during the visit.

Misconception #3: Real-time is key – collect while the patient is present.

  • Many providers believe that if they do not collect patient responsibility while the patient is in the office, they will waste a lot of time and money making phone calls and sending statements to the patients, and often will not collect.  This is true; however, processing refunds to patients can cost over $20 per transaction in administrative costs.  Plus, back office collections can be efficient and successful if you put the right tools in place to achieve payment assurance.

To do: Enable patients to pay through automated payment plans by saving payment cards on file.  Prior to each payment, send automated notifications to patients so they are aware of upcoming payments.

Note: To securely collect patient payments, it is essential to use not just a PCI “compliant” solution, but a PCI “certified” solution, which means it has been certified through an independent audit process.  As a technology best practice, you also should encrypt the patient’s payment card at the point of interaction (click here for more information).

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