Handling Problems With Self-Pay Patients

Self-pay patients aren’t as rare as they used to be, largely due to high deductible health plans (HDHPs). There are also a large body of patients who choose to self-pay because they can’t afford insurance premiums, are in-between jobs, or may be experiencing any number of other issues that prevent them from signing up for a reliable healthcare plan.

For some of these patients, self-pay is the only option and the cost of care is an uncomfortable burden.

Healthcare is expensive and even more, it’s an industry rife with unexpected emergencies and unpredictable needs. Preventive care and regular check-ups may be the preferred method of dealing with all illness and injury—stopping problems before they start— but reality is rarely that simple.

For self-pay patients, an emergency can be nearly life-altering in terms of medical costs, and practices could face significant challenges ensuring bills are covered where self-pay patients are involved. According to some statistics, 81 percent of net revenue from self-pay patients generally goes uncollected, and a full 30 percent of these individuals tend to default on payments.

Handling these self-pay patients effectively, whether for short-term, preventive care payment plans or long-term emergency costs, is essential. Below are five elements your practice can use as a foundation for building an effective self-pay system, one designed to bring in more on-time payments and less bad debt.

A clear payment policy

Step one with any new arrangement for your practice is setting up clear standard operating procedures and policies. As self-pay patients become more common, it is essential for your practice to create a clear and comprehensive payment policy that addresses procedures for dealing with self-pay patients who are both insured and uninsured. Each will need to be handled differently and will have different needs and risks. Research and plan accordingly for issues that could arise with these individuals.

Verifying insurance and patient responsibility up front

For both HDHP and elected self-pay patients, everyone should know before they walk in for an appointment that a payment plan may be necessary. By checking insurance coverage and setting a clear pricing scale upfront, you can help patients better manage the costs associated with basic treatments or preventive care.

Online patient billing

All consumers love easy payment options, and your patients are no different. Make it easier for them to meet their payment needs by setting up an online payment option. You can even institute a recurring payment option that will allow for their regular payment to be deducted monthly with no hassle or work on the part of your team or the patient.

Effective, consistent communication

Communicating expectations up front is a must with self-pay patients. Continuing to communicate throughout any payment arrangement is equally essential. If a payment has been missed, sometimes a simple phone call or email discussing their options can prompt patients to make the call and handle the issue. Most patients genuinely want to take care of their bills. Friendly reminders that your office is more than willing to make that possible can go a long way in building an amicable relationship and securing the patient’s commitment.

Patient advocacy

According to an article from the American Academy of Family Physicians (AAFP), one solution to the issues surrounding uninsured self-pay patients is hiring a patient advocate. “These staff members,” the article stated, “direct patients in managed care plans to the right referral specialists, pharmacies and ancillary centers, thereby boosting patient satisfaction and helping to control costs.” Essentially, their job is to help patients find the best resources to help them afford the cost of care from more than just your practice. The role could be very influential in building patient confidence, doctor-patient relationships, and in helping improve the health outcomes among your patients.

Is Value-Based Care Making an Impact?

Learn More

Practices that are experiencing issues with self-pay patients do have options. By carefully assessing current policies and redesigning an approach to meet patients’ needs, you might be surprised at the results.

Most importantly, however, is starting with the patient in mind and building from there. By creating a patient-friendly self-pay process, you can remind patients that the ultimate goal is their overall health and happiness—a goal that includes ensuring they can afford the cost of care even without insurance or low deductibles.

Female doctor hand hold silver pen filling patient history list at clipboard pad. Physical, exam, er, disease prevention, ward round, visit check, 911, prescribe remedy, healthy lifestyle concept