Patients are a provider’s third largest payer, right behind Medicare and Medicaid. Just as it’s getting more challenging for providers to collect from payers, it’s also getting more difficult to collect from patients. An analysis of patient collection rates at 1,850 hospitals and 250,000 physicians across the country shows a significant decrease between 2022 and 2023. The results revealed a collection rate of just 48%, or approximately a quarter of the total amount owed.
More than half of all bad debt write-offs are from patients with insurance.
While there is no single cause of sluggish collection rates, industry experts agree that the widespread adoption of high-deductible health plans (HDHPs) is a major contributing factor. Today, more than half of employees working in the private sector have an HDHP with an average maximum deductible for a family of $16,100.
The most effective way to improve collections alongside the patient experience is to remove financial barriers so patients can afford to get the care they need when they need it.
Patient Access Opportunities
The patient access process not only sets the stage for a positive patient experience but also for a healthy revenue cycle. Traditional patient access workflows are highly manual and prone to error, which can lead to issues down the road.
Insurance and eligibility verification
Insurance and eligibility verification is an excellent area to address. Incorrect or missing information is one of the top reasons claims are denied. When claims are denied, providers can experience delayed or inaccurate reimbursement. Denials due to inaccurate insurance information can also lead to surprise patient bills for services that should have been covered.
Patient Scheduling
Another opportunity for pre-service improvement is scheduling. Scheduling is often the patient’s first encounter with a provider, and increasingly, patients want more convenient scheduling options. Consider how quickly consumers have adopted online scheduling for dinner reservations, salon visits, appliance repair, and grocery delivery. Why not give them the same convenience for self-scheduling their medical appointments? The best options to offer are through an online portal, via text messages or a mobile app, and over the phone with an automated voice recognition system.
Providing self-scheduling options can reduce no-shows by 17%.
Price Transparency
An additional pre-service opportunity to improve collections and the patient experience is to increase price transparency. Consumers would scoff at the idea of purchasing a car and wait a few months to find out what it costs, but that’s what they’re forced to do with their medical bills in our complex healthcare system. This lack of transparency makes it challenging for patients to plan and budget for care.
Providers can help by educating patients about their financial responsibilities using patient responsibility estimations before or at the time of service. With a printed estimation, providers can explain to patients about their copays and remaining deductibles, along with the total price of the service. Having this information prior to a service empowers patients to make the best decisions about their care. In this way, the provider acts as an advocate and partner in the patient’s healthcare journey, which can help improve patient satisfaction and collections.
In a survey of 1,500 patients, 90% said that provider loyalty depends on the patient financial experience.
Next Steps
These are financially challenging times for patients, which has made it challenging for providers to collect. The opportunities mentioned above can help improve the patient experience in pre-service while ensuring patients are able to pay for the care they need. In doing so, providers make it easier to collect while creating happy, loyal, healthy patients. For providers who may lack the time or resources to implement these improvements, Revenue Enterprises can help.
At Revenue Enterprises, our experts deliver proven patient access and accounts receivable solutions to healthcare organizations nationwide. We immerse ourselves in our clients’ healthcare missions and uphold their culture of care through every stage of the revenue cycle. We operate on the principles of integrity, passion, and respect. Embodying these three simple words helps us set the standard in patient access and accounts receivable management services and deliver the best in outstanding patient experiences and results. They’re not just our founding values; they’re the foundation of our approach and our clients’ success.