Overcoming Upfront Patient Balance Collections

Overcoming Upfront Patient Balance Collections - PracticeForces

Did medical school prepare you for acing patient balance collections? We all know the answer, but patient balance collection is undoubtedly one of your biggest challenges as a medical practice owner. Yes, patients are the new payers; however, over 60 percent of patients cannot pay hospital bills in full. A 2018-2019 Federal Reserve Survey on the economic well-being of U.S. households concluded that even an unplanned expense of $400 could prove to be difficult for 40 percent of the population. The pandemic exaggerated the problem, with the unemployment rate touching 14.8% in April 2020, the highest since record-keeping began in 1948 (Source Congressional Research Service).


A major cause of delay in patient balance payment is the lack of transparency in expected medical expenses. If the patient is not communicated an accurate cost estimate, it could be months before the medical practice receives a payment. To be fair, it is not always a lack of communication by a medical practice that makes it challenging to collect on patient payments. There is unpredictability in the level of clinical decision-making, which can be evaluated accurately only once the patient meets the physician. Therefore, a level three office visit may turn into a level four.


Lack of patient awareness of what their insurance pays for is another common hurdle. It’s estimated that most patients are not aware of their co-pay or deductible. The responsibility then falls on the medical practice frontline staff to help patients understand their coverage and their share of cost responsibility.


How to Improve Upfront Patient Balance Collections


With five months to go before the year ends, a focused approach now can still radically boost your patient balance collections. Here are three ways to improve upfront patient balance collection at your medical practice.


1) Decide that upfront collection is an important revenue goal.


As practices and patients alike adjusted to meet the challenges that came with the pandemic, the collection of patient balances took a backseat. However, we now know that the pandemic situation will improve and worsen cyclically. So, it’s crucial to bring the focus back on upfront collections. The start point is to have a clear and reasonable financial policy:


-Does your medical practice have a clear financial policy for patients?

-Have you updated it in the last two years?

-Have all your existing patients signed the current financial policy?

-Do you ensure that all new patients sign the financial policy at the time of first-time registration?

-Does it spell out the patient’s responsibility for planned visits to your medical office? For instance, patients must carry their insurance card and verification, and payments must be made upfront at the time of service.

-Do you offer a payment discount for patients who pay upfront?

-Is your financial policy accessible? It should be on your website as well as displayed in the patient waiting area.


2) Train staff to talk money


Asking patients for money is a conversation that should be handled politely but clearly. Inevitably, it will be your front-end staff that will have to ‘talk money.’ Ensure that your team is trained on answering commonly asked questions on insurance policy coverage, deductibles, co-pays, and understanding which medical procedures require prior authorizations. Staff must be trained on explaining the out-of-pocket expenses to the patient.


If your practice has staggered repayment plans, your front-end staff must know how to assess which patients qualify for such an offer.


3) Enable different payment methods to appeal to different segments


This is what an ideal appointment booking workflow should look like:


-The staff assesses the insurance eligibility and informs the patient of the due amount.

-Staff confirms an appointment with the patient.

-Staff informs the payment options available to the patient and emails any pending forms.

-As soon as a patient accountability is recorded on the system, an automated payment due update is sent to the client via email and mobile text.

-The patient makes payment through one of the online payment options.


Offering multiple payment options that include secure online payments, mobile payments, and credit cards on file will make it possible to collect at least 30 percent more of your revenues upfront. However, a certain percentage of your patient may require extra guidance in making that first online payment, which can be resolved through a call by your billing staff (or outsourced medical billing partner).


As a U.S. based medical billing company, we are mindful of the revenue challenges faced by medical practices since the COVID outbreak in early 2020. And we have been actively working with our clients to meet those challenges.


Outsourcing medical billing will help your medical practice cope with the cyclical changes in patient volumes as the uncertainty around the pandemic continues. With the backend of medical billing taken care of, you will have more resources at your disposal for patient engagement and offering value-based-healthcare. Contact us to know how we can be of help to your medical practice.

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