4 Biggest Patient Billing Challenges

March 6, 2018

The healthcare industry has no shortage of challenges, and revenue cycle management is no exception. A 2016 survey of healthcare organizations identified several such challenges with patient billing in particular. Self-pay patients are on the rise, and so too the importance of patient collections continues to increase. Fortunately, many of these problems have solutions just waiting to be implemented.

Challenge: Estimating Patient Financial Responsibility

Patients who are surprised by a larger-than-expected bill are less likely to pay promptly, as their budgets will need to absorb the hit. One of the best ways to avoid surprising patients with unexpected medical bills is by providing them with an estimate of their financial responsibility before care is provided. Healthcare organizations should build in automatic eligibility verification and cost estimations by routinely using software with these capabilities either prior to or at the point of service. Copay expectations should also be made clear to the patient, and these should be collected in full at check-in.

Challenge: Educating Patients about their Financial Responsibility

Many patients are confused or overwhelmed by insurance coverage and medical billing. Especially given the rise of high-deductible health insurance plans, patients are assuming a greater share of healthcare costs. Healthcare organizations should anticipate common points of patient confusion and have infrastructure in place to support patients in understanding the responsibilities they will take on. This education can range from identifying a need for insurance pre-authorization to providing financial counseling and offering alternatives to lump-sum payments.

Challenge: Patients Who Take a Long Time to Pay

The 2016 survey of healthcare organizations found that slow-paying patients posed a significant challenge to their businesses, but more than half of those organizations surveyed did not submit electronic statements to patients, more than half did not offer automated payment plans, and only 35 percent of the respondents retained payment cards on a secure system. It is not surprising that patients will take a long time to pay if the billing system lags behind the digital experience that consumers expect and that modern technology easily supports.

Challenge: Patients Who are Unable to Pay

Of course, there are the patients who take a long time to pay … and then there are the patients who never quite get around to it. The approaches to the previously discussed challenges will also help with patients who would otherwise likely have difficulty paying. In addition, it is important to make patient collections simple, direct, and timely. Ensure that patients are offered a wide variety of payment options to remove barriers to payment. Many healthcare organizations collect partial or full payment prior to providing patients services, or another option is storing a payment method for automatic payments in accordance with a payment plan decided on in advance of services being provided.

With all of these challenges, the solutions seek to leverage available software tools and maintain good patient relations through transparency and clear communication. The earlier challenges can be identified and intercepted, the better the outcomes will be.