Even though high-deductible health plans (HDHPs) are now ubiquitous, many physician practices still struggle to collect patient balances.

In fact, 83 percent of physician practices with fewer than five practitioners cited slow payment of HDHP patients as their top collection challenge, according to the Black Book 2017 Revenue Cycle Management Survey. Their second biggest challenge, according to 81 percent of respondents: communicating patient payment accountability.

That’s a problem, considering that patient financial responsibility now accounts for one-third of healthcare organizations’ revenue, according to various estimates. Therefore, patient collections should be an area of continuous improvement.

Key areas of focus include financial policies and procedures, employee training, and patient engagement and communication, says Reed Tinsley, CPA, a consultant specializing in healthcare accounting. “Nine out of 10 patients couldn’t tell you what their copay or deductible is,” he says. “It’s incumbent upon the practice to educate the patient.”

Here are five expert-recommended steps that can help practices rise to these challenges.

Draft financial policies

A clear and reasonable financial policy is the first step in setting expectations with patients about their payment responsibilities. At Coastal Medical of Rhode Island, for example, new patients receive a copy of the practice’s financial policy as part of a welcome packet, says Marilyn Boichat, the group’s director of practice management. “When the patient checks into the office for the first time, we have them sign that they read and understand it,” she says. Patients who indicate they need further clarification are invited to come into the office and discuss the policy with the practice manager privately, she adds.

In general, the policy explains what patients are expected to bring to every visit, such as their insurance card and identification; their responsibility to contact their health plan about specific coverage questions; and that payment is due at the time of service unless alternate arrangements, such as a payment plan, have been made.

Coastal also offers a prompt payment discount for patients who choose not to use health insurance, she says. The discounted fee cannot go below the Medicare allowable and is due at the time of service. “For patients who have a hardship [out of their control], such as losing their job and their health insurance, we will discount the visit [further], and the patient is offered a payment plan to pay when they can afford to,” Boichat says.

In addition to having patients sign off on financial policies and posting them on the practice website, practices should consider placing hard copies of the policy in their reception area, says Ken Hertz, FACMPE, a principal consultant with the Medical Group Management Association (MGMA). “Particularly at the beginning of the year, when deductibles reset, it’s a good idea to make this information available for patients to review while they’re waiting to see the doctor,” he says.

 

Offer ongoing staff training

Inevitably, practice employees will encounter patients who are unclear about various insurance terminology, such as the distinctions among deductibles, coinsurance, and copayments, and how that translates to their out-of-pocket expense.

“If you want to collect the money that’s owed to you, you have to be willing to invest some time in making sure staff are trained to help, as a way of showing patients you care about them,” Hertz says.