How Personalized Patient Payment Plans Benefit Your RCM

By David Shelton, CEO, PatientMatters
Twitter: @PatMatters

One of the most difficult conversations that takes place in a hospital doesn’t always occur between a physician and patient. It happens between the patient and registration staff, wrapped around the question, “how are you going to pay for your visit today?” Direct patient payments represent the fastest growing share of hospital receivables today, yet the way most hospitals deal with helping patients manage their financial responsibilities can be inconsistent, subject to workarounds, and decentralized across departments.

Registration Challenge
The hospital registration staff is one of the lowest paid, highest turnover positions in a hospital, yet they bear the critical responsibility of informing patients or guarantors about their payment obligations. These hard-working professionals typically try their best to collect from patients, but are often using methods that aren’t conducive to the collections process. For example:

  • Many business offices and registration teams lack integrated workflow tools and timely information for effective communication with patients at the time of service.
  • Registration staff sometimes have limited experience in influencing patient collections and do not have insight into the patient’s current financial situation.
  • The entire process is awkward, with both parties trying to get the collection process over with so the patient can move on to their designated care area in the least amount of time.

Patient/Guarantor Challenge
During the registration process, the guarantor’s top priority is getting themselves, or a family member, the best and most appropriate care as quickly as possible. An all too common occurrence is when the patient or guarantor rushes through the registration process and ends up not fully understanding their insurance, what they owe, or how they are going to pay for it.

Doctors don’t use the same clinical solution for every patient, and hospitals shouldn’t attempt to apply the same payment plan for every guarantor. With a traditional “one size fits all” approach, many hospitals train registration staff and financial counselors to set up guarantor payment plans that maximize collections over the shortest period of time. This canned approach generates a higher patient default rate, forcing more patients into bad debt status and increasing hospital collection costs.

The Solution
The good news is that forward-thinking provider organizations are working to change all of this and deliver a positive financial experience by rethinking their revenue cycle management from the top down. By taking a holistic approach that combines key business functions with data-integration tools and proven best practice training strategies, provider organizations can enhance the patient’s experience of care, and improve the hospital’s overall profitability. Best practices and strategies for transforming the revenue cycle include:

  • Integrating siloed business functions, including registration, billing, collections, and financial support. This way, staff can speak to patients with a direct message that’s tailored for each individual patient.
  • Coaching staff to engage with patients in this integrated way and treat them with compassion as valued customers.
  • Providing accurate bill estimates prior to care so that patients know what to expect to pay, and when.
  • Customizing patient payment plans.
  • Referencing propensity-to-pay data and analytics so hospitals can better predict the right mix of services, payment options and financial support.
  • Expanding payment options to include individually-driven payment plans, payment portals and direct lending to patients.

Creating personalized financial solutions for every patient ensures that they will know what to anticipate from a financial perspective by having a realistic plan to meet these obligations, and that they can trust the provider organization to be fair and helpful. Organizations that have embraced these principles are seeing significant and measurable rewards, including improved collections, HCAHPS scores and net promoter scores, and an overall better patient experience.

These transformations let healthcare organizations deliver consumer-friendly patient financial services that reduce the stress of care, drive brand loyalty, and improve their bottom line by offering patients the financial options and compassionate advocacy that they deserve.