A Provider’s Guide to the Patient Financial Experience

Patients are facing increasing out-of-pocket costs, such as high premiums, deductibles, and copays. A recent consumer experience study revealed that 53% of patients find it stressful to understand their healthcare coverage and the amount they owe.1 To avoid confusion, ensure clarity in payment obligations, and provide a patient-friendly experience, it is crucial to compassionately educate patients about their healthcare coverage and out-of-pocket expenses. This guide presents a 10-step approach to tailor your payment strategy and optimize collections while prioritizing satisfaction throughout the patient financial journey. 

1. Clearly Define Patient Responsibility Upfront 

Many patients are caught off guard when they realize that insurance does not cover all their costs. As patient responsibility rises, it is important to ensure that patients understand their out-of-pocket expenses. Provide patients with estimates for the services your practice will provide. Additionally, offer a breakdown of pricing differences between health plan covered services and self-pay options, enabling patients to choose the most cost-effective approach. A clear understanding of patient responsibility upfront will save time, improve overall patient satisfaction, and prevent billing disputes. 

2. Offer Detailed Explanations for Service Charges 

Patients, like consumers, want to understand what they are paying for and the associated costs. Be prepared to provide a line-item bill detailing each service provided and its corresponding charge. Note the differences in cost between insured patients and self-pay patients. Stay up to date with your coding, as CPT codes are used for billing and can be used to generate a line-item bill. Additionally, laws such as the No Surprises Act, require you to provide Advanced Explanation of Benefits to patients who request the document.  

3. Educate Your Patient on Services Covered by Insurance 

Health insurance plans are complicated. It can be difficult for patients to determine on their own what services insurance will cover. There is also a growing demand for cost transparency. Leverage your expertise working with insurers in your network to help patients gain a clear understanding of what their plan covers. For out-of-pocket costs, help the patient determine if their payment can be applied to their deductible.  

4. Make Patient Payment Easy and Convenient 

Research indicates that patients prefer using mobile payment options to pay their bills. Invest in a system that offers digital payment capabilities, allowing patients to pay their bills with a few clicks. Make sure the system is secure to protect credit card information. For patients uncomfortable with online portals, provide paper bills with clear payment instructions. Streamlining billing and payment processes will improve your collection rates while reducing payment turnaround time.  

5. Keep Credit Cards on File 

Collecting and storing credit card information accelerates patient payments, eliminating the need for patients to repeatedly re-enter payment credentials. This also allows for automatic payments to be debited to credit cards on file, saving time for all parties. Ensure you employ a system that provides robust security measures to safeguard credit card information. 

6. Understand Who Your Patients Are 

Your patients are not a homogenous group. Age, gender, income, and a host of other demographics create variables in patient behavior. A method of communication or a payment option that works for one person may not be comfortable for another. Take the time to understand your patients and tailor your communication and payment options to their preferences.  

7. Focus on Communication 

Reach your patients how they prefer and use multiple communication channels. Each patient is different and has a preferred method of communication. A combination of mail, email, text, and phone will ensure your patients have the information they need to pay their bills and that their questions are answered. 

8. Show Compassion and Empathy  

Healthcare costs have reached unprecedented levels. Many patients are facing financial insecurity. This can be a serious obstacle in collecting patient payments. Use a call center staffed with customer experience specialists who talk with your patients and not to your patients. This provides an opportunity for you to clearly outline the patient’s responsibility while working with them to come up with a feasible payment plan. 

9. Provide Affordability Options 

When working with patients, be sure to offer affordable options. Examples include flexible payment plans or incentives such as one-time discounts on high balances. This will alleviate some of the financial burden on your patients, improve their interactions with your practice, and prompt them to pay on their outstanding balances. Utilizing payment portals and convenient payment options will help accelerate these patient responsibility collections as well. 

 10. Choose a Qualified Partner 

When it comes to patient experience, work with a partner you trust. Be sure their values and approach align with yours and that they have the capabilities to provide a superior end-to-end patient experience. Patient satisfaction should be measured continuously and reported back consistently. Working with a trusted partner can considerably boost your patient payments and your revenue yield. 

1 https://revcycleintelligence.com/news/consumers-dont-pay-patient-financial-responsibility-after-bad-experience 

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Koha Health has been acquired by Veradigm. Please read the Press Release for more information.

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