Improve Practice Revenue – Identifying Patient Payers

It would be easy to assume that you’ve recognized and maximized on each of your practice payers’ arrangements. After all, insurance companies and providers have worked in tandem for years, developing relationships that are well-understood. However, one payer group tends to get overlooked more than the rest: the patients. Too many administrators neglect the fact that patients as payers account for a significant percentage of practice revenue – to the tune of 35 percent as of 2016. But since patients aren’t granted the same considerations as every other payer, providers can miss out on a huge potential revenue stream.

Patient payers account for 35% of practice revenue

A 2019 report released by InstaMed revealed that patients had experienced a 162 percent increase in deductible burden over the past decade. This data tells us that patients are financially responsible for a higher portion of their medical care than ever before. Even still, many care administrators don’t have a transparent strategy for obtaining, communicating, and achieving payment from patients.

The good news is, developing a plan that treats your patients as payers is obtainable. This article will help you streamline your operational efforts in order to capture complete reimbursement and achieve patient-payment success. If you need additional support in this area, reliable and knowledgeable billing and administrative professionals are available to offer you and your team assistance so you can focus on what matters most – your patients.

Step 1 – Identifying patients as payers

Strictly speaking, every patient you treat is a payer. There are few, if any, patients who aren’t financially liable for at least some portion of their care. As a result, every patient should be given honest and open communication about financial policies and expectations. The number of patients with high-deductible insurance coverage continues to rise and you’ve probably noticed that you have even more high-deductible patients than you did just a few years ago. 

This is no time to get complacent in your reimbursement strategy. With just a little planning, patients with high deductibles (and therefore a greater likelihood of increased financial responsibility) can easily be identified by staff or medical billing professionals. Maintaining transparency and open lines of communication with every patient right from the beginning increases receivable efficiency as well as builds trust between patients and providers.

Step 2 – Familiarize yourself with out-of-pocket costs

Boosting revenue and avoiding extended collection times, starts with building your knowledge of patient benefits. An overwhelming 89 percent of patients report that they prefer to know their payment responsibility upfront, and 85 percent say they enjoy using technology that helps them estimate the cost ahead of time. Even more telling, 65 percent of patients are reportedly more willing to make a payment if they knew the estimated cost at the time of service. 

Based on these findings, giving your patients an accurate cost estimate is crucial to getting paid by this cohort. Don’t leave the calculation to chance and don’t leave patients in the dark. Resources like Payer/Provider Portals allow staff members to access detailed benefits information including how much of the deductible has already been met and how much the patient is responsible for before insurance kicks in. 

Gathering this information, coupled with the complete understanding of your fee schedule, will allow you to better educate each patient payer about their financial responsibility. As a result, patients will be much more likely to fulfill their financial obligations to your practice if they are equipped with the information upfront. 

Step 3 – Adopting patient-payment policies

In a healthcare climate where patients’ deductible burden has become so great, patient-payment policies should be of top priority if you want to capture this commonly overlooked revenue stream.

If it’s been a while since you reviewed your payment policies, taking the time to do so could uncover explanations for drops in patient payments. For example, ten years ago it may have been reasonable to uphold a financial policy requiring patients to pay for services, in full, within 30 days. But now that deductibles are over twice the amount that they were a decade before, practices have to take into consideration that the patient financial burden is greater, and thus, they should have more time to settle. Consider exploring more flexible payment policies that would stand to benefit both the patient and your practice.

Step 4 – Find the right digital solutions

There are many ways you can strengthen patient payer relationships through the payment experience. The vast majority of patients (84 percent) pay non-healthcare bills online, this demonstrates an incredible opportunity for practices to capitalize on this already established consumer behavior – with online payment.

Online payments can be processed at the patient’s convenience – increasing the probability of medical bill remittance. Another method growing in popularity is the enhanced payment portal, which allows patients to securely store card information for future or recurring payments. This also increases the likelihood that patients will continue paying for care.

Step 5 – Monitoring your key performance indicators

The best way to measure the success of your efforts and ensure you capitalize on this revenue stream is to regularly monitor key performance indicators (KPIs). Be sure to generate reports with the proper parameters in order to obtain the best insights. 

Ask yourself the following: 

  • Is outstanding patient AR decreasing? 
  • Are more payments being collected at time of service? 
  • What portion of payments collected are coming from the patient portal? 

Each of these KPIs will provide valuable data for you to gauge the success of your patient payment strategy. 

Seeing patients as payers is a huge part of growing and maintaining a financially healthy modern practice. By using transparency and clear communication in every encounter, practices and patients can work together to ensure satisfaction and success for all involved.