Article Highlights

• The vast majority of Americans do not have a full understanding of health insurance.
• Educate patients on their patient financial responsibility before providing services.
• Consider outsourced resources from PMB to support revenue collection.

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If you want to receive more payments for services provided, there is an underrated tactic to consider for your practice. Help educate your patients on their healthcare plan and patient financial responsibility!

This is valuable to increase revenue collections because patients are paying a lot of attention to their medical bills, and they expect you to participate in helping them out. Consider these statistics on patient expectations:

• 89% of patients want to know complete payment information upfront.
• 85% of patients want a website that estimates their balance before they visit you.
• 84% of consumers already pay their non-healthcare-related bills online.

Essentially, patients are tired of receiving big bills that are higher than what they expect to pay for services months later. What many patients have done is selected health insurance with a high deductible, leaving many claims below their deductible as an out-of-pocket expense. It isn’t until they received services that they understood exactly what their financial obligation would be, especially because the coverage listed out on an insurance card is confusing to many patients.

This matters to healthcare providers because it often leads to issues where the provider experiences slow payments or no payment at all from patients who suddenly realize that they will have to pay for certain services that they thought were covered by insurance.

One way to help your organization with revenue collection is to provide education to patients on their insurance patient financial responsibility. By proactively educating patients and attempting to resolve issues beforehand, you can increase the collection of payments for your medical services.

Common Causes of Healthcare Revenue Collection Issues

A patient attends a scheduled appointment, obtains healthcare services, and then is unable to pay for their patient financial responsibility when the bill comes in the mail. You know this happens all too often, and it puts a strain on providers who are trying to care for patients. 

– Many reasons why patients are unable to meet their medical financial obligations can be resolved through a series of pre-appointment checks that assist in the decreased likelihood of uncollected revenues months later after the patient has been serviced.

The inability of a policyholder to understand their health insurance coverage or a lack of knowledge regarding covered services is the main cause of patient payment deference. Assisting patients in understanding insurance plan coverage and encouraging them to contact their insurance carrier for more specific information is the first step in increasing revenue collection.

At Precision Medical Billing, we can help. We provide this service to providers that we bill for, helping your patients better understand their benefits.

An additional step you can take is to provide patients with an estimate of their financial obligation for a variety of expected services and procedures before they are rendered. This gives the patient access to information to make an informed decision about whether to continue with services, especially elective services, or hold off until they are in a better financial position to receive the services or set up a payment plan to pay for the service to be rendered.

– Patients who don’t realize they are getting out-of-network care or are unsure of their health plan network also contribute to increased billing amounts and the associated lack of payment.

From primary care to emergency services, it is critical for patients to understand which providers are in-network. As a health professional, it is your job to assist them in discerning this, when possible. Checking this item off the list during pre-patient care can help increase the likelihood of patient payments.

Taking Responsibility for Patient Financial Education

Lengthy contracts, confusing terminology, and result-specific coverage can inevitably cause any patient to misread or misunderstand the details of their health plan coverage. This can leave patient financial responsibility up in the air until the final bill arrives in the mail.

If your practice or facility desires to improve your revenue collection rate, then consider adding some pre-care steps into your patient engagement process. Help patients understand what their insurance coverage will cover — or what their financial responsibility will be if they do not have health insurance.

PMB suggests entities estimate the financial responsibility of a patient for a given procedure prior to the scheduled date. This allows patients to prepare for their portion of the payment that will be due ahead of time and allows you to accurately communicate your expectations along the way.

– For example, you may structure your services to require a set amount of payment at the time of services to cover the office visit and then another payment for the actual services. You want to inform patients about their obligation for the actual procedure beforehand so that they know what that cost will be, also.

Most patients believe everything done in the office is covered by their co-pay and don’t understand that the co-pay usually only covers the office visit of being seen by the doctor to determine the problem. However, to fix the problem is a completely different cost. The key is letting the patient know at the time of service what the additional costs are and accepting payment at the time of service — or setting up a payment plan.

Regardless of your approach, you can help increase your revenue collections through proactive upfront communication and honesty with the patient. You don’t want to surprise your patients with an unexpected bill.

How Precision Medical Billing Can Help 

Consider this stat. According to a recent survey by TransUnion Healthcare, 75% of today’s patients expect to receive price transparency so that they can better understand their out-of-pocket patient financial responsibility before receiving services. In other words, don’t surprise your patients. Do your part by being transparent about costs!

By doing your part upfront, you can help increase your rate of collections. This includes helping answer questions and providing education to patients about their financial obligations.

At Precision Medical Billing, we want to help you optimize your revenue collections. By investing more time in educating patients on their financial responsibilities, you will find you have more time for routine medical billing and coding which is the lifeline of revenue collections in your practice. This is where PMB steps in to help.

Not only can we optimize your facility’s revenue cycle process, but we can also assist in increasing the rate at which payments are received through our outsourced billing and coding services.

If you are interested in streamlining your revenue cycle management or outsourcing your medical billing and coding to a team of experts, look no further than Precision Medical Billing. We are here to help you in any way possible, and we can get started when you call us today. We look forward to hearing from you.