How to Improve Point of Service Collections Through Better Patient Engagement

Posted on July 19, 2022 by Kylene Ordway

Patient financial responsibility for healthcare costs has grown rapidly over the past few years, rising from 5% to 35% in two decades. Today, patients are now the third-largest payer behind Medicare and Medicaid.

This increase in responsibility can be challenging for healthcare providers when it comes to collecting revenue. However, it is also challenging for patients. High-deductible health plans continue to drive patient financial responsibility increases as they make patients more financially accountable for healthcare.

A 2017 study showed that most hospitals were only collecting from 35% of their patients, which accounted for just 19% of patient financial responsibility. Yet, in the same study, 90% of practices agreed that point-of-service patient collections were crucial to a successful healthcare revenue cycle.

There are many things healthcare providers can do to increase collections from patients and ensure patients are seen, despite their level of coverage.

Casey Williams, Senior Vice President of Patient Engagement for RevSpring believes patient engagement “comes through a culture of improvement and innovation that is measured.” He believes focusing on specific outcomes for patients is the “lifeblood of engagement.”

Strengthening point-of-service patient collections is key to recouping payment for healthcare services and improving healthcare revenue cycle management.

Train Front End Staff To Engage Customers About Payments

No matter the industry, talking about money owed can be difficult and uncomfortable. However, studies have shown that only around 57% of providers discuss a patients financial responsibilities.

Engaging customers so they know what they owe is crucial. Front end staff should be trained to have conversations about payments with patients. Training staff on patient responsibility is important and allows them to feel comfortable navigating difficult conversations.

Front end staff can also ask patients how they will pay, rather than if they will pay. Even a simple shift in language can shift the expectations of the customer.

Better front end staff education can boost point of service collections by focusing on ensuring staff:

• Understand how patient responsibilities are calculated
• Know what information is needed to process a claim
• Understand how co-pays and deductibles work
• Learn what other front end responsibilities employees manage

Not only is staff training necessary for their confidence. Patients are more likely to trust a transparent healthcare organisation that provides them with precise information.

Bring Revenue Cycle Management Functionality Into The Front Office

Along with additional training, front end staff can benefit from having access and training in revenue cycle management functions that traditionally live in the back office.

A lack of communication between the point of service staff and the back office can lead to communication breakdowns and siloed patient information. In addition, when staff are only familiar with their area of the revenue cycle management process, payments or errors that lead to delays can slip through the cracks.

Many staff are only familiar with a singular role they perform, whether scheduling, registration, or billing. By requiring staff to perform patient financial checks upfront, healthcare organizations can create a more seamless revenue cycle management system.

With patient registration and eligibility verification moved to the front end, staff can check that their insurance covers patients before seeing a doctor. Then, providers can share this with patients before they come in for their appointment. This way, patients are aware of where their insurance ends and their personal financial responsibilities begin.

Having the appropriate information in the system, staff can calculate accurate payment estimates at the point of service and submit cleaner claims. In addition, precise information provides the groundwork for claims to be billed and collected quickly and efficiently.

Introduce Customer Friendly Payment Options

Although patient financial responsibility is increasing, healthcare organizations are still in the business of customer service. This means that if patients are frustrated with providers who lack the technology or service they expect they will seek out a better experience at a competing hospital or clinic.

Healthcare organizations also need to understand that placing barriers between patients and payments only harms their bottom line.

For patients, credit cards, smartphone payment, and online payments are par for the course in other service industries. Healthcare organizations should do everything they can to bring new technology into their systems and make the barrier to payment easier.

Manual payment methods are slow and make it difficult for point of service staff to collect on the full amount of services rendered. Some healthcare organizations only allow patients to make payments during business hours or only accept certain types of payments.

Many patients take care of the bills outside of work hours, or just can’t find the time in their day to spend half an hour on the phone organizing a payment. A report by Instamed revealed that 70% of patients preferred to pay by electronic payments such as credit cards or online.

Additionally, roughly half of the respondents said they would consider changing providers if it meant they could pay by their preferred method.

Increase Price Transparency To Help Patients

For many patients, a lack of transparency is what is preventing them from paying up. Healthcare organizations are rarely forthcoming with the cost of their healthcare service costs upfront. In no other industry are consumers expected to pay a bill without having any idea of the cost beforehand.

Healthcare providers need to have clarity within their own organization of what their costs are and detailing this information clearly on a patients bill. Far too often, providers are unable to clarify what services rendered were when a patient has an enquiry about their bill. Providers should be able to complete price estimates for patients when asked.

One way to provide this information with patients without taking up precious time from the point of services staff is to display it on the website. Just as patients budget for things like groceries and car servicing, being able to accurately budget and plan for medical expenditure is important. In fact, this is no longer a nice-to-have.

With the passing of the Hospital Price Transparency rule, hospitals must publish machine-readable files online that outline their payer-negotiated payment rates and must provide patients with a tool to search and view the prices of their medical services.

Create a Patient-Centric Collections Strategy

To truly improve the customer experience and collect revenue at point-of-service, healthcare organizations need to develop a collections process that focuses on the customer as an individual. Every patient has a different financial situation and providing a strategy for payment that caters to them is paramount.

Mr. Williams says, “Engaging the patient in the right way, through the right medium/technology and presenting the right message” drives the best outcomes for both patients and providers. 

That said, healthcare providers should start by focusing on collecting payment no later than at the time of service. With the majority of providers still collecting payment after service is delivered this will be a big shift for many.

But patients are no longer only owing small portions of the overall payments. If providers don’t focus on a more patient-centered strategy they risk doing damage to their bottom line and ultimately to patient satisfaction.

With just a 30% chance of collecting payments from patients after they leave their appointments, providers need to prioritize point-of-service strategies to secure their bottom line.

To improve point-of-service collections, healthcare organizations can:

• Collect or arrange for payment no later than the time of service.
• Offer multiple ways to pay such as automated phone systems, online payment portals, digital payment tools, and FSA/HSA cards.
• Use communication tools for payment notifications customized to each patient’s preferences.
• Leverage propensity-to-pay analytics to inform the financial conversation and identify options such as financial assistance or charity care.
• Provide flexible payment plans.
• Create statements that are clear, concise, and easy to understand.
• Ensure all departments are following the same collections practices to create a consistent patient financial experience.

Ask Your Patients How To Best Serve Their Needs

Ultimately, there is no one-size-fits-all model for collecting revenue from patients. What is effective is reviewing and monitoring what is working and refining what isn’t. One place that healthcare providers can begin is by asking their own staff and their patients what is and isn’t working.

Start by asking internal staff what parts of the revenue cycle management process are creating friction. Whether it’s collecting payments on time, integrating patient communications or driving patient satisfaction, your internal staff are good indicators of the gaps that are in your processes.

Set up monitoring of the following areas as you work towards improving the revenue cycle management process:

• Self-payment collections: Measure pre-service, time of service and post service. By focusing on improving the first two (through front office tasks, increased price transparency, and customer-friendly payment options) post-service payments should drop.
• Patient satisfaction: keep a record of patient satisfaction both clinical and financial, specific by issue or complaint. This will give you a good indication of areas to improve. If patients complain about not being able to pay bills by their preferred methods, or not being able to understand their bills, mark these complaints as areas for improvement.
• Cost of collection: Providers lose money by bills going further through the revenue cycle. Collecting earlier in the revenue cycle is cheaper and allows for more costs to be recovered. Developing a more patient-centric model should help improve the cost of collection.
• Bad debt metrics: Identify problematic areas via bad debt trends. Identifying the gaps could be as easy as training staff to ask for payment at the time of service.

Once again, Mr. Williams believes focused outcomes are the key to patient engagement. And that mentality starts before patients walk through our doors. What outcomes are you driving? Everyone in your entire organization engages patients on some level. It is critical to meet the patient where they are with the best possible communication methods possible. Machine learning and predictive analytics can be deployed to understand these outcomes even before a patient is seen can dramatically increase yield, reduce unneeded costs and drive up patient satisfaction.