Prioritizing the Patient Financial Conversation

According to a recent survey by HIMSS Analytics and Waystar—in which more than 1,000 patients and 900 healthcare finance leaders provided their care cost and payment perceptions—patients indicated they are willing to pay their healthcare bills. Fully 85 percent of respondents feel the same responsibility for their healthcare bills as they do for other expenses. However, just because a patient is amenable doesn’t mean they will make a payment. The survey also revealed that less than 20 percent of patients with commercial insurance plans find healthcare bills easy to understand and convenient to pay. This figure points to a prime opportunity for healthcare organizations to better engage patients in financial conversations to make the payment experience more informative and user friendly. 

Strategies to Increase Patient Payment

There are several strategies that can yield a strong patient financial interaction. 

Verify insurance and generate an upfront cost estimate. Before sitting down with a patient to talk about care costs and payment, organizations should verify the individual’s insurance coverage and benefits. In addition, providers should generate a cost estimate of what the patient will owe after insurance adjudication. Revenue cycle technology can simplify this process, gathering the information in near real-time. 

Armed with the data, financial counselors can speak with patients about what they owe and how they can pay. Patients appreciate receiving cost estimates, and those who get one are more likely to pay up front, the survey found. They also are more likely to return for future healthcare needs and recommend the healthcare organization to others. 

Although most organizations can generate estimates (more than 80 percent according to the survey), only one in five patients receive one without asking for it. By sharing cost estimates as a matter of course, organizations can better meet patient needs and drive payment.

Ensure any necessary approvals are in place. For those procedures that require a pre-authorization, financial and clinical staff should work together to obtain that approval and identify any potential roadblocks. Without proper authorization, a health plan could deny a procedure and this can change the nature of the patient financial exchange. The patient may have to decide whether to proceed with self-pay, delay the procedure until the authorization is complete, or not have the procedure at all. By obtaining pre-authorizations in a timely fashion, an organization can mitigate these financial and clinical risks. 

Provide straightforward payment methods. After reviewing the cost estimate with the patient, there is a window in which staff can ask the individual to make a payment—either partial or in full. It is helpful to have mechanisms in place to receive those payments, making it easy for the patient to pay. The survey found nearly 75 percent of patients like to make payments using their credit or debit cards, so at a minimum, organizations should have a way to accept these payment methods. Providers may want to go a step further and securely store the patient’s credit card information and charge it up to a certain dollar amount after insurance adjudication. The survey indicates that 20 percent of patients would agree to this option. Not only does it guarantee payment for the provider, but it makes the process easier for patients as well.  

Offer payment plans when warranted. Sometimes the amount a patient owes surpasses their ability to pay and can cause anxiety. Organizations should provide staff training to listen for patient cues regarding concerns and respond accordingly. For example, if patients hint they may delay a procedure because they can’t afford it, organizations should empower staff to recommend payment plans, or offer plans up front for higher-cost procedures. Financial counselors should know how those payment plans work and be able to set them up before patients leave the premises. 

In the current climate of tighter margins, healthcare organizations cannot afford to lose revenue because of poor communication with patients. By embracing the idea of financial conversations and putting processes and technology in place to enable and simplify them, organizations can improve their revenue, decrease stress, and improve patient satisfaction.

Matthew J. Hawkins is the CEO and a board member at Waystar, Louisville, Ky.