With more patients signing up for high-deductible health plans, many medical practices are looking to patients for a growing percentage of their revenue. As a result, experts say, it's more important than ever that patients — and your entire staff — understand the details of patients' coverage and how much they will be required to pay.
"Many patients are now self-insuring for the first $2,000 to $3,000 of their bills and there will be some tension around that change," said Lloyd Van Winkle, a family practitioner in a two-physician practice in Castroville, Texas, and a member of the board of directors of the American Academy of Family Physicians. "Patients need to know their financial obligations in advance so they won't be caught off guard or placed in an embarrassing position when they arrive in the office."
Before implementation of the Affordable Care Act, insurance reimbursements accounted for the bulk of a practice's collections while patient copays were almost an afterthought, noted Scott Koenig, president of Lima, Ohio-based KeyBridge Medical Revenue Care. With patients now responsible for a larger portion of the bill through high-deductible plans, practices need to pay more attention to educating staff about coverage and payment issues and training them to communicate effectively with patients.
"In the past, patient satisfaction was based on the clinical experience but now patients are also taking note of what happens during the registration, billing, and collections phases," said Koenig. "Practices need to position themselves accordingly because the collectability of an account goes up drastically when a patient is satisfied with their experience."
Start by formally documenting your office's procedures and policies regarding payments so that everyone on staff can talk knowledgably about patient payment issues, said Van Winkle. A staff member should be available to review the policy with patients on their first visit and to discuss any questions they might have about their coverage and payment options.
Communication is key because patients are more likely to take their financial obligations seriously when they have a strong relationship with their practice, experts say. Consider the following tips:
• Look up and understand patients' coverage before their visit. Whether through a simple phone call or encouraging patient verification of demographic and insurance information via the patient portal, staff should be proactive in knowing what plan they are dealing with prior to the patient walking in the front door.
• Set expectations as early as possible. Let patients know that they will be getting a bill so they are not surprised when it arrives.
• Be prepared to discuss flexible payment plans. Make everyone on your staff aware of the financial arrangements available to patients. If staff members work with patients on payments, they may be more willing to make monthly payments via a debit card or credit card, especially if they understand the options well.
• Deliver clear and consistent messages. "When patients don't trust the information you give them, they don't pay," said Koenig. Make sure all staff can explain the details of a bill and answer questions in a way the patient can understand.
• Take advantage of the "inter-visit" space. Collection discussions aren't limited to in-office visits. Use prescription refill requests, upcoming patient appointment reminders, and other communications to remind patients about an outstanding balance.
• Build relationships. Any kind of communication, whether financial or health related, increases the likelihood of receiving prompt payments.