Even before the coronavirus pandemic, close to 25% of Americans said they put off necessary care due to costs.[1]Since the pandemic, economic pressures have skyrocketed with hundreds of thousands losing jobs and employer-sponsored health insurance. In a recent health tracking poll conducted by KFF, 31% of participants said they had fallen behind on their bills or have had trouble affording expenses like food or health insurance due to the pandemic.[2] The same poll found that 48% of people knew someone who had put off care due to the pandemic, with 11% suffering deteriorating conditions because of it.
The point is that patients are suffering in terms of their health and their finances. If you think it was difficult to collect prior to the pandemic, challenges have become much more formidable. Your approach to this situation is what separates great health systems from good health systems. Those using aggressive collections tactics will, indeed, struggle to collect. Health Systems and Physician organizations that turn their attention toward creating a more patient-centric revenue cycle that meets patients in their new reality will reap the rewards of increased collections, improved outcomes, and enhanced patient loyalty.
Creating a more humanized revenue cycle requires a new way of thinking, one that focuses on helping patients afford the care they need when they need it. Following are four opportunities to create a more compassionate and efficient revenue cycle—both so important during these challenging times.
Rethink your patient registration process. In most cases, the patient’s first encounter with your organization is the registration process. It’s the experience that sets the tone for the entire patient journey. It can be frustrating to sit in a waiting room with a clipboard of paperwork, digging through your wallet for insurance information, driver’s licenses, and phone numbers of employers and personal contacts. What should be a welcoming experience ends in frustration before the patient is even seen.
A better approach is to implement a virtual registration process. Instead of patients having to fill out myriads of paperwork, a virtual registration specialist can take care of recording the information and verifying demographic information. Managing the registration process in this way not only improves the patient experience, it also helps reduce down-stream rejections and denials due to inaccurate or missing patient information.
Nearly one-fourth of all denials are due to issues during the registration process.[3]
Make it easier for patients to pay. Looking back when patient responsibility meant a small co-pay or nothing at all, there was rarely a need for payment plans or financial assistance unless the patient lacked health insurance. That’s no longer the case. With the popularity of high-deductible health plans, even patients who are fully covered often need assistance paying their bill. Health systems and physician organizations can improve the likelihood of getting paid and help improve patient loyalty by acting as an advocate in helping patients afford the care they need.
Two options for making it easier for patients to pay include offering financial assistance and patient payment plans. Being able to identify which patients qualify for financial assistance helps both you and your patients. The process of applying for that assistance can be difficult for patients, but you can provide guidance throughout the process. This includes collecting required documentation, filling out all necessary paperwork, and following up after submission. So many patients are going through a hard time right now and helping them through this process with dignity and compassion can increase loyalty and help improve your brand identity.
Offering payment plans is another great way to improve the patient experience and to keep accounts from going to collections unnecessarily. Wouldn’t it be better to start collecting payment immediately rather than waiting 90 days and only receiving partial payment through an early-out vendor? The best payment plans include easy-to-use portals where patients can self-select payment plans, view balances, and make one-time or recurring payments, that meet their financial capacity as well as provider guidelines.
Shore up your denials management process. Payer denials negatively impact both you and your patients. This is especially problematic for CARC 22 denials, or order-of-insurance coverage issues where the claim should have been billed to a different insurance carrier. While the denial impedes cash flow for your organization, it often means your patient gets billed for a service that is actually covered.
The best way to prevent these types denials and avoid upsetting patients with a bill they didn’t expect is by ensuring claims are accurate before they’re submitted. This means collecting and verifying all pertinent insurance information during the registration process. Real-time eligibility verification can ensure that all primary and secondary insurance information is collected up front, reducing the likelihood of denials for you and unexpected out-of-pocket costs for your patients.
Consider partnering with third-party resolution experts. Many health systems and physician organizations avoid outsourcing all or portions of the revenue cycle because they believe they don’t have the financial resources necessary to do so. But when the right partner is selected, the ROI can multiply. The best vendor/partners are those that understand their impact on your brand reputation and patient loyalty. They are experienced and act as an extension of your organization, treating patients with the same care and compassion as you would.
For more than 35 years, health systems and physician organizations have placed their trust and patient relationships in the hands of HBCS. Clients benefit through improved payer reimbursements, increased self-pay collections, reduced costs, and enhanced patient satisfaction and loyalty. HBCS clients have experienced:
- 37% average increase in patient account collections
- 74% improvement in average speed of answer
- 98% satisfaction based on automated post-call survey
- 20% increase in insurance collections
- Up to 65% reduction in insurance inventory
Bringing the human touch to the revenue cycle
The COVID-19 pandemic has impacted health systems and provider organizations across the country, as well as patients. Incorporating the human touch into your revenue cycle with technology, analytics, transparency, and personal service is the best way to protect your bottom line and long-term financial viability.
[1] https://www.cbsnews.com/news/nearly-40-of-americans-cant-cover-a-surprise-400-expense/
[2] https://www.kff.org/report-section/kff-health-tracking-poll-may-2020-health-and-economic-impacts/
[3] http://cthima.org/wp-content/uploads/2018/12/CTHIMA-Payer-Denial-Trends-Rocky-Hill-Dist-12.13.2018.pdf