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It wasn’t that long ago when third-party payments were the dominant force in the way healthcare providers were paid. Things have changed at a rapid pace, and we’re now well into the new norm of high-deductible health plans (HDHPs). With 44 percent of employers reporting in PwC’s 2013 Touchstone survey that they are likely to only offer HDHPs in 2014, patients will continue to bear more responsibility for the payment of their care.
That means providers need to work smarter, not harder, to collect those patient payments to stay afloat. While there are many ways to reduce bad debt, such as making follow-up calls to patients with past-due balances, one efficient and economical approach is to simply send a more readable bill. If patients are confused about their statements, they’re more likely to pick up the phone with questions than pick up their checkbook to pay the bill.
In several focus groups conducted earlier this year, patients participating in three fully blinded sessions across a range of demographics shared their feedback. The goal was to determine what does and does not work in patient statements and use this research to improve statement design. Patients shared the following feedback.
Billing statements affect patient opinions and satisfaction. In each group, one or more participants stated that they believed insurance providers’ information about care encounters to be more reliable than information from their healthcare providers. The patients expressed frustration when hospitals send bills that are unclear, and they reported concerns about discrepancies between statements and explanation-of-benefit documents, noting that mismatched information generates the need for calls and inquiries to gain clarification.
Details are important to patients. The focus groups revealed that simplicity of information in billing statements does not equate to the exclusion of details. Participants resoundingly stated that they need billing details that are presented in a simple fashion and stated clearly. If they don’t have the itemization of services or other details, they wait to receive all the information they require before making payment. Many participants said they clarified their charges by calling their provider.
The core strategy revealed through the study is to “focus on clarity of information.” Clarity is not the exclusion of details, but rather it is the clear, concise, and logical conveyance of complete information.
Well-designed statement summaries can be effective tools. After reviewing a series of statements intentionally designed to improve clarity of information, participants responded with top-of-mind thoughts. These reactions were dramatically more positive in comparison to cluttered statements that were only printed in black and white.
Provide a summary page and itemized details. Patients responded positively to billing statements that provided both summary pages and itemized details. Effective summary pages highlight the key points: amount owed, date due, and where/how to send payment. Account detail pages offer descriptive line items to document all aspects of care, serving as useful explanation of the account summary page.
As patients take on more of the financial responsibility for their healthcare expenses, revenue cycle leaders can make the payment process easier for patients by providing clearly defined statements and summary pages. Removing barriers to understanding hospital financial communications improves patients’ overall opinion of the provider and enhances patient satisfaction.
Emdeon assists providers in creating clear, concise patient statements that result in effective patient communications.
Publication Date: Monday, November 18, 2013
TriMedx helps health systems control costs and uncover savings opportunities by optimizing the clinical engineering function.
Patient financial engagement is more challenging than ever – and more critical. With patient responsibility as a percentage of revenue on the rise, providers have seen their billing-related costs and accounts receivable levels increase. If increasing collection yield and reducing costs are a priority for your organization, the metrics outlined in this presentation will provide the framework you need to understand what’s working and what’s not, in order to guide your overall patient financial engagement initiatives and optimize results.
A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow.
No two patients are the same. Each has a very personal healthcare experience, and each has distinct financial needs and preferences that have an impact on how, when and if they chose to pay their healthcare bill. It’s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients. The need to tailor financial conversations and payment options to individual needs and preferences is critical. This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach, but take control of rising collection costs.
Emad Rizk, MD, president and CEO of Accretive Health, discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management.
This white paper, written by Apex Vice President of Solutions and Services, Carrie Romandine, discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle. Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs, but it will maximize the amount collected before sending to collections. Further, targeted messaging should be applied across all points of patient interaction (i.e. point of service, customer service, patient statements) and analyzed regularly for maximized results.
Jim Bohnsack, vice president, solution & corporate development for Conifer Health Solutions, explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements.
This white paper, written by Apex President Patrick Maurer, discusses methods to increase patient adoption of online payments. Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections. This white paper shows why patient-centric approaches to online payment portals are important complements to traditional provider-centric approaches.
Steve Scibetta, senior director of channel sales for Ontario Systems' healthcare product line, shares insights into effectively managing receivables.
Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs. This article, written by Apex Founder and CEO Brian Kueppers, explores a number of strategies to create synergy between patient billing, online payment portals and electronic health record (EHR) software to realize a high ROI in speed to payment, patient satisfaction and portal adoption for meaningful use.
Elena White, vice president of risk, quality, and network solutions for Optum, discusses how healthcare providers can leverage data and technology as they enable risk in their organization.
Faced with a rising tide of bad debt, a large Southeastern healthcare system was seeing a sharp decline in net patient revenues. The need to improve collections was dire. By integrating critical tools and processes, the health system was able to increase online payments and improve its financial position. Taking a holistic approach increased overall collection yield by 10% while costs came down because the number of statements sent to patients fell by 10%, which equated to a $1.3M annualized improvement in patient cash over a six-month period. This case study explains how.
Somnia President and CEO Marc Koch, MD, MBA, explains how hospitals can drive transformative change in the perioperative experience for outstanding clinical and financial outcomes.
With the ICD10 deadline quickly approaching and daily responsibilities not slowing down, final preparations for October 1 require strategic prioritization and laser focus.
PMMC President Roger L. Shaul discusses the effects of healthcare reform on revenue cycle management and how PMMC's products help clients adapt to a changing financial environment.
Read how Gwinnett Medical Center provides clear connections to financial information, offers multiple payment options for patients, and gives onsite staff the ability to collect payments at multiple points throughout the care process.
Greg Burgess, Founder and Chief Product Officer at Burgess Group shares insights and opportunities for payment integrity in the rapidly changing healthcare IT landscape.
Read how Orlando Health was able to perform deeper dives into claims data to help the health system see claim rejections more quickly–even on the front end–and reduce A/R days.
To maintain fiscal fitness and boost patient satisfaction and loyalty, healthcare providers need visibility into when and how much they will be paid–by whom–and the ability to better navigate obstacles to payment. They need payment clarity. This whitepaper illuminates this concept that is winning fans at forward-thinking hospitals.
Financial services staff are always looking for ways to improve the verification, billing and collections processes, and Munson Healthcare is no different. Read about how they streamlined the billing process to produce cleaner bills on the front end and helped financial services staff collect more than $1 million in additional upfront annual revenue in one year.
Effective revenue cycle management can be a challenge for any hospital, but for smaller providers it is even tougher. Read how Wallace Thomson identified unreimbursed procedures, streamlined claims management, and improved its ability to determine charity eligibility.
Before launching an energy-efficiency initiative, it’s important to build a solid business case and understand the funding options and potential incentives that are available. Healthcare leaders should consider taking the steps outlined in the whitepaper to ease the process of gaining approval, piloting, implementing, and supporting sustainability projects. You will find that investing in sustainability and energy efficiency helps hospitals add cash to their bottom line. Discover how hospitals and health systems have various options for funding energy-efficient and renewable-energy initiatives, depending on their current financial structure and strategy.
Health care is a dynamic mergers and acquisitions market with numerous hospitals and health systems contemplating or pursuing formal arrangements with other entities. These relationships often pose a strategic benefit, such as enhancing competencies across the continuum, facilitating economies of scale, or giving the participants a competitive advantage in a crowded market. Underpinning any profitable acquisition is a robust capital planning strategy that ensures an organization reserves sufficient funds and efficiently onboards partners that advance the enterprise mission and values.
The success of healthcare mergers, acquisitions, and other affiliations is predicated in part on available capital, and the need for and sources of funding are considerations present throughout the partnering process, from choosing a partner to evaluating an arrangement’s capital needs to selecting an integration model to finding the right money source to finance the deal. This whitepaper offers several strategies that health system leaders have used to assess and manage capital needs for their growing networks.
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