Going to the hospital is not like going to the supermarket, but it should be. Follow along:
Imagine you’re walking into a supermarket to buy some cereal, milk, and coffee. You grab a cart, head over to the dairy cooler, and find some 2 percent milk from the brand you like.
“That’s funny,” you think idly. “No price tag on here.” You’ll ask at the front, you suppose. Next, you head on over to the cereal aisle to grab some Raisin Bran and Golden Grahams, and find the same thing: no price tags. Finally, on the way up to the cashier, you grab a bag of pre-ground, medium roast coffee only to see that it too has no price listed.
You get to the express lane, place your items on the belt, and the cashier asks how you’re doing. “I’m fine,” you reply. “But as far as I can tell, everything in this store is free! I haven’t seen a single price listed on anything.”
“Oh, we don’t price things here,” she says, bagging up your items. “We’ll bill you in 30-90 days. And remember: you may receive separate bills for your dairy and non-dairy items.”
While this isn’t typical at the checkout counter, it’s exactly the way healthcare pricing and payments work. Healthcare is one of the only industries in which you receive services for which you have no idea what the final cost will be before paying for them. It’s no wonder that hospitals and healthcare systems want to increase cash flow at the point of service while also increasing the patients’ knowledge of how the process – and the financing of it – works.
How can you accelerate point of service (POS) cash and collections, as well as elevate awareness about the issue?
Establish policies: Without a clear and consistent policy around POS collections, both staff and patients are left in a confusing gray area rife with many exceptions and not enough uniformity. Instead, publish a straight-forward policy in plain sight for both staff and patients, and empower managers to steadily enforce it to ensure accountability. There should be no doubt about what the expectations are around how, when, and what the patient should pay.
Leverage marketing: Hospitals and healthcare systems should do everything in their power to broadcast the expectations around POS collections to their communities. This can involve everything from scripted messaging for pre-registration and check-in staff to pamphlets, ads, web pages and blog posts. The message should be loud and clear around what portions of the patient financial responsibility are due at time of service and how the organization can assist individuals in meeting it, whether it’s through a payment plan, coverage discovery, or standard payment modes including cash, check, or credit card.
Make it educational: With 74 percent of insured patients indicating they are both willing and able to pay out-of-pocket medical expenses of up to $1,000 per year – and a full 90 percent willing and able to pay up to $500 a year – it is imperative that hospitals and health systems educate patients early and often on what they owe and why they owe it. Leveraging estimator tools and following high-touch pre-registration workflows go a long way in getting patients informed and ready, willing, and able to pay at POS.
Get the most out of technology and innovation: In the digital age, there are many more ways than paper or plastic to make payments. Optimize payment processing by giving patients options beyond cash, credit card, or check. Electronic payment apps like Square, Venmo, and Google Wallet; Near-field communication digital wallets like Apple Pay, Android Pay, and Visa Checkout; and even “pay by text” options meet the evolving needs of payers and providers. Additionally, take advantage of technology for transparency and communication as well. Many EHRs and/or web-based apps allow for constant, transparent communication between hospitals and patients, all while remaining HIPAA compliant.
Data, data, data: While all of the above will assist in consistent, continuous payments at point-of-service from a patient perspective, it’s imperative that your staff maintains good collections performance. Utilizing best practice KPIs and benchmarks is key to achieving this, along with regular, data-driven reporting. For example, the National Association of Healthcare Access Management (NAHAM) recommends using a “Collections Opportunity” statistic for tracking; best practice organizations collect 60 percent out of their total estimated collections at POS. Further, they recommend that two percent of all Net Patient Revenue is collected at POS. Keeping your teams tied to these benchmarks with daily, weekly, or monthly goals – along with incentive campaigns – can ensure consistent, best practice-level performance month over month.
Just like shoppers wouldn’t want to be surprised months after they made a purchase, the archaic get-service-now-pay-later model no longer works for healthcare. It’s imperative that hospitals and healthcare systems go above and beyond when it comes to informing patients of their financial responsibility and consistently following through on collecting it. Making payment systems more consumer friendly can help providers minimize uncompensated care and alleviate confusion and frustration among patients.
Reed Wilson is a senior consultant, EHR at Avaap. Get in touch and learn how modernizing your payment system can give your healthcare organization a competitive edge.