5 Tips for increasing self-pay patient collections

It's no secret that the number of self-pay patients has increased dramatically in recent years. The current state of the sluggish economy means that fewer people receive health insurance through employers, and nearly all of those who are lucky enough to be insured must pay higher copays and deductibles. These increases mean patients' self-pay portions of their bills go up, often leaving providers struggling to collect from them.

"So many patients have higher deductible plans, they're effectively becoming self-pay patients," Ken Saitow, managing director and revenue cycle solution leader at Chicago-based Huron Healthcare, told FierceHealthFinance. "Healthcare organizations may need to adjust their collections policies to reflect this different patient profile."

In these changing times, it always pays (literally) to keep focus on the collection basics. Consider these five tips for collecting from self-pay patients:

1. Improve upfront communication with patients

Provide patients with advance estimates of financial obligations based on their insurance coverage. "It is vitally important to treat patients with financial excellence before they experience the clinical excellence," said Rebecca T. Black, vice president of revenue cycle at Saint Joseph's Hospital of Atlanta. "Our financial counselors will explain options upfront like payment plans and discounts for early cash pay and help them understand their health savings account, for example." Having these upfront communications can benefit both patient and provider.

2. Give patients every opportunity to pay

Provide patients with multiple choices and opportunities to pay. Julie Ingraham, director at Huron Healthcare, said this is an area where hospitals have made huge strides, but there is usually more that can be done. Even though the days of patients having to stand in line to write checks with multiple forms of ID have passed, hospitals still can make the experience easier on patients. "Most hospitals aren't doing everything they could, either. That includes taking money upfront, check-in kiosks, online payments, payments by phone, e-checks-anything that streamlines the process will help," Ingraham explained.

Patients often feel more satisfied when they have more payment options too. "It may feel like collecting from patients isn't providing good customer service, but it is because this can allow them to focus only on their medical situation without financial distractions," Ingraham added.

3. Continue to evaluate current practices

This is no time to rest on your laurels. For example, if you're not asking your emergency department patients to pay their copays upon admission, you're missing out.

"For years, we wouldn't even consider asking for money in the ER, but now we collect $20,000 per month," said Vice President of Finance Mark Bogen at South Nassau Communities Hospital in Oceanside, N.Y. "Anything we can do to cut collection costs later is a huge victory on the back end."

Other hospitals that traditionally have questioned collection upon admission also are considering changing their policies.

"Faith-based hospitals have been the laggards on this because they worried it distracted from their mission," said Elizabeth Guyton, revenue cycle lead at Accenture Health in Chicago. "But now, even they're realizing how important it is."

Guyton also said more people are willing to outsource various parts of the revenue cycle. "People are getting much more comfortable from a cost perspective with outsourcing," she said. "Even offshoring is now more widely accepted. CFOs who told me five years ago they would never do that are considering it because they have nowhere else to cut costs."

4. Don't ignore any of your accounts

With today's increasing transaction volume and leaner staff headcounts, it can be tempting to let some accounts slide, but be wary not to.

"I want 100 percent of my clients' accounts being worked regularly, whether that means running them through the system, putting them up on the dialer, or looking at collection strategies," Guyton noted. Every account counts. In addition, be willing to pay a percentage to the person checking the accounts as well, according to Guyton.

5. Keep current with vendors

You may not have time to stay up to date with every technological improvement that can help ease your revenue cycle woes, but your vendors do. One technology garnering a lot of attention now is positive biometric authentication.

"It's well known that NYU has implemented a biometric hand-scanning system to combat fraud," Guyton said. "Now we're getting a call a week from potential clients who want to know if this technology will work for them because they know we're up to date."

Your vendors can prove their worth on other issues, too. "My vendors help me do my job as efficiently as possible," Black added. "From correcting patient addresses on up in complexity, it's hard to increase your collections if you can't even contact your patients properly. My vendors know which of the latest technologies might streamline things for me, and I appreciate it."

By improving internal processes, such as communications with your patients and vendor, as well as external processes, such as paying careful attention to accounts and current practices, your hospital or health system could reap the rewards the you've been missing out on.

The above article is excerpted from "Hospital Revenue Cycle: Successful Strategies to Boost the Bottom Line," a FierceHealthFinance eBook published last month. For more information, download the eBook here. Also check out another special report, "Patient collections: 7 Fierce strategies to getting paid."

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