by Richard Altman

In part one of our three-part series on improving patient collections, we talked about the increase in patients as providers’ largest “payer,” especially with the proliferation of high deductible health plans (HDHPs). As well, we offered ways to make bill paying easy for patients, since as the Consumer Financial Protection Bureau’s Report “Consumer Experiences with Debt Collection: Findings from the CFPB’s Survey of Consumer Views on Debt” found, 31% of healthcare consumers did not find bills simple to pay; 42% found medical bills unaffordable, and 47% did not understand cost beforehand.

In part two, we discussed ways to improve your patient receivable by collecting payments at the earliest point possible in the revenue cycle, particularly focusing on the first 90 days, since according to accounting firm Abo and Co., accounts even up to 90 days old still have a 90% chance of being paid.

In this last of our three-part series, we’ll talk about the importance of not wasting time trying to collect payments from the wrong party or at the wrong address.

Verify Eligibility

Don’t waste time submitting claims to the wrong insurance company. Verify insurance information at each visit and check eligibility for every date of service. For patients who do not provide insurance information, check to see if they are covered by Medicaid or another government sponsored plan. And when claims are denied for eligibility reasons, contact patients immediately to get updated or correct information.

Maintain Updated Contact Info

A patient who doesn’t respond to a bill may not actually have received it. To ensure your statements get to the right place, verify contact information at every visit. Also, utilize the USPS Address Service Requested program to get updated mailing address information for patients who have moved and left forwarding information.

Finally, when patients do provide updated contact information, including addresses, telephone numbers, and email addresses, be sure to update them throughout the patient’s account record, especially the billing screens.
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Don’t let growing patient balances balloon your accounts receivable and create a barrier to the patient-physician relationship. Instead, try these three collection methods to keep your patients—and your bottom line—happy.

by Richard Altman

In part one of our three-part series on improving patient collections, we talked about the increase in patients as providers’ largest “payer,” especially with the proliferation of high deductible health plans (HDHPs). As well, we offered ways to make bill paying easy for patients, since as the Consumer Financial Protection Bureau’s Report “Consumer Experiences with Debt Collection: Findings from the CFPB’s Survey of Consumer Views on Debt” found, 31% of healthcare consumers did not find bills simple to pay; 42% found medical bills unaffordable, and 47% did not understand cost beforehand.

In part two, we’ll discuss ways to improve your patient receivable by collecting payments at the earliest point possible in the revenue cycle.

Point of Service Collections

A 2015 survey by Availity called The Impact of Consumerism on Provider Revenues revealed that physician practices were able to collect the full amount requested during point-of-service collection efforts from 56% of patients. That same survey showed that in 2017, physician practices expect to use point of service efforts to collect at least partial payment from 44% of patients.

Train your staff to have collections on their mind at the earliest points of contact, such as paying past-due balances when scheduling appointments or paying copays and known coinsurances when checking in for a visit.

Timely Statements

When collecting copays or co-insurance at the point of service is not possible, ensure patients receive statements as close to the date of service as possible through regular and frequent statement cycles, including eStatements. According to accounting firm Abo and Co., the earlier invoices are paid, the more fully they’re paid. For instance, the average recovery rate for a 30-day-old invoice is 97%, while recovery on a year-old debt drops to 47%.

“Issue invoices as soon as feasible, preferably coincident to the providing of the service or sale of product,” Abo and Co. recommend. “Delaying can lengthen the payment period.”

Collection Letters

Consider sending a pre-collection letter for balances that aren’t paid in two statement cycles. According to Abo and Co., accounts that are 90 days old still have a 90% chance of being paid, but clearly your normal statements are not creating the intended effect.

According to Robert C. Scroggins, in his 2014 Modern Medicine article “Collecting patient bills: When to use a collections agency,” an official-looking letter might get noticed when statements otherwise aren’t. Also, sending letters on practice letterhead but from a party other than the physician—like an office manager—might help deflect some negativity away from the patient-provider relationship.

Finally, Scroggins recommends enlisting the help of a third party to send the letters, as “they will be looking for a list of delinquent accounts monthly. When handled by internal staff, separate pre-collection letters become a low priority behind charge entry, payment posting, routine insurance follow up and monthly statements.”

Placement with a Collection Agency

At some point in the revenue cycle, the billing office’s attempts at collecting patient payments are no longer justified. That does not mean, however, that the past-due balance won’t be collected. Even delinquent accounts up to 180 days old still have as much as a 67% chance of being collected. And collection agencies often have methods for reaching patients, like GLA’s Collector Activity approach, that medical practices and billing companies do not have at their disposal.
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In Part 3, we’ll wrap up our series by talking about the importance of not wasting time in trying to ollect payments from the wrong party or at the wrong address.

by Richard Altman

​It’s no secret in the healthcare industry that patients are quickly becoming one of the largest “payers” providers are collecting payments from. According to the March 2017 HealthLeaders Media article, “The Rise of the Third Payer: Disrupting Patient Payment Culture,” nearly 1 in every 3 workers with employer-sponsored health insurance were enrolled in high deductible health plans (HDHPs) in 2016, up from 1 in 20 a decade earlier. The Kaiser Family Foundation learned that 2016 also was the first year that “half (51%) of all covered workers face deductibles of at least $1,000 annually for single coverage.”

Meanwhile, a January 2017 study issued by the Consumer Financial Protection Bureau called “Consumer Experiences with Debt Collection: Findings from the CFPB’s Survey of Consumer Views on Debt” found that of 1,000 healthcare consumers polled, 28% said they weren’t confident bills were accurate; 31% did not find bills simple to pay; 42% found medical bills unaffordable, and 47% did not understand cost beforehand. What’s more, a 2016 study by Connance found that patients who were not satisfied with their healthcare provider’s billing process were less likely to pay their medical bills in full (33 percent) than patients who were satisfied (74 percent).

So how do you address the large patient balances that are filling up your accounts receivable while also acknowledging the increased patient desire for the same high levels of customer service present in other service industries? In part one of this three-part series, we’ll discuss ways to improve your patient collections while also improving your relationship to your patients by making bill payment easy.

Make Bill Paying Easy

Interestingly, the majority of insured consumers (74 percent) say they are able and willing to pay their out-of-pocket medical expenses up to $1,000 per year, and as many as 90 percent would pay for medical expenses up to $500 per year. So, why don’t they? A 2009 McKinsey Quarterly survey found that “a lack of options for payment plans, poor timing of bills, and difficulties coping with confusing statements or policies were major barriers to paying.”

But patient billing isn’t brain surgery. Save that for the operating suite. Instead, make paying bills as easy as possible for patients right from the beginning.

Easy Estimates

Start by providing easy-to-understand and transparent cost estimates prior to the service, and discuss payment options at the same time. According to that same 2009 McKinsey Quarterly survey, 52 percent of consumers said they would be willing to pay from $200 to $500 or more by credit or debit card when they visit a physician if an estimate was provided at the point of care.

Simple Statements

After the service has been provided, send statements that include everyday-language—not just a bunch of alphanumeric codes—and be sure the amount owed and the due date is clearly listed. And for patients who prefer it, send statements in eFormats, with links to your payment portal or other online payment options.

Ample Options

Still collecting patient payments through mailed statements and payments? You’re not alone. According to BillingTree’s 2016 HealthCare Operations and Technology Survey, the vast majority of healthcare providers still collect payments through the mail (93%) or through an agent over the phone (87%). Web portals came in third at 66%. Interactive Voice Response (IVR) systems were used only 7% of the time, and mobile and text payments, only 13% of the time.

But patients want these more options to make bill paying convenient to their busy lives. Also, be sure patients know when they do have other choices. Post your financial policies clearly in your office and on your website, including all the formats in which payments can be collected.

Proactive Payment Plans

Finally offer payment plans, too, with options for recurring automatic payments so that you receive payments each month with no additional intervention. But be sure to prompt patients to pay the bill off as quickly as possible. One Georgia-based family practice realized that when they suggested a $25 monthly payment, nearly every patient took it, regardless of whether they could have paid more. Instead, they began asking patients to pay 10% of the total bill each month, with the goal of having the bill paid off within a year. GLA’s Time Payment Plan offers payment schedules ranging from two to thirty-six months, depending on the amount due and the patient's financial situation.

Look for Part 2 of this series next week, when we’ll discuss the importance of collecting payments at the earliest point possible in the revenue cycle.