Patients Are the New Payers

A lot is changing in the world of healthcare. New laws, new coding standards, and new ways of viewing patient care are just a few of the main transitions that many practices are now undertaking. Wrapped within these larger changes are hundreds of little ones related to operating policies.

One concept of the old status quo that needs serious re-evaluation is the heavy dependency on insurance payouts. Traditional operating procedures leave most practices relying on patients only as far as copays, while the rest of the funding for patient care is expected to come from the insurer. That method has become increasingly undependable, as copays increase and the amount of uncollected patient financial responsibility continues to grow.

Healthcare professionals, if you hope to avoid thousands of dollars in unpaid patient debt, it is time to consider some new alternatives. The best of the available options is also the simplest: work with your patients.

Get the facts and communicate them clearly.

If your practice is not already prequalifying, it should start immediately. Getting the facts upfront about patient obligations is essential. Roughly 25 percent of all healthcare payments come directly from the patients. They are responsible, typically, for between 20 and 40 percent of general healthcare costs. For the uninsured, the responsibility is a full 100 percent. Your practice can use this understanding to communicate clearly with the patient about expectations and obligations and come up with a plan before services are rendered and the cost is accrued. Good communication can go a long way in preventing a bad debt situation before it happens. Of course, if you can collect up front—do it. Get that debt out of the way. But for more unusual circumstances, clear expectations are essential.

Step outside of the current system—break the bubble.

Currently, a large percentage of healthcare payments come from insurers, and that is not likely to diminish hugely in the future. However, copays are increasing and even with the tax penalties levied by recent legislation on the uninsured, some patients may still need to cover 100 percent of costs on their own. Getting up to speed and ahead of the competition may mean thinking creatively about how to make costs and payments more manageable for the patients—i.e. the payers. Ultimately, working with the patients and setting up an effective system for proactively managing patient debt will result in a lower percentage of bad debt and a better bottom line for your practice.

Rethink how you view the patient.

Patients are not simply gateways to insurer funds. As stated above, the patients take on a portion of their care and insurers will supplement that cost, but the patient is ultimately responsible for any costs accrued. Its important to talk to patients, explain the pertinent information, and work to find a middle ground for healthcare payments and patient needs. The movement in healthcare right now is the treatment of the whole patient, preventive care, and a movement towards a better sense of interaction and connection between healthcare providers and patients. You want your patients to walk out feeling like you had their best interests in mind, and they will, in turn, have a more positive image of the healthcare industry and—hopefully—of their own health goals. A positive approach is always more attractive than a negative one and is likely to yield more results.

Most doctors agree: patients need to take more responsibility for their own health. Early steps in encouraging that kind of mindset begin with the formation of a good patient-healthcare provider relationship. By acknowledging and working with patients on their healthcare payments, perhaps even expanding billing and AR departments to provide better customer service and more frequent contact, healthcare providers can foster a positive relationship for patients—even if it is about money—because they can prove to patients that they care and want what’s best for them and their health. Sometimes, just knowing someone actually cares beyond the numbers can make all the difference.