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4 Steps to Resolving Patient Accounts

4 Steps To Resolving Patient Accounts

Ensuring that your patients pay on time and in-full is the crux of resolving patient accounts. More often than not, however, helping patients navigate the self-pay collections process is as complicated and challenging for you as it is for them. You could be missing out on key revenue simply because you don’t have a plan in place that maximizes your efforts. Here are four steps to take that will get your organization on the right track to developing an efficient system for resolving patient accounts.

 1. Develop a plan

The foundational concept you should have for your accounts resolution process is understanding that not all guarantors have the same propensity or ability to pay their hospital bills. And what’s more, not all patients/guarantors understand their liabilities even when faced with what seems to be a straightforward statement. The healthcare business is confusing to many. Therefore it’s crucial that you develop a plan for the different types of accounts you may face and strategize a way to handle each. Start by classifying your accounts into these recommended “buckets” and then stratify the risk within each bucket.

The Types of Accounts

  • Balance after insurance payment
  • True self-pay (uninsured)

The Risks

  • High balance/Likely to pay
  • High balance/Less likely to pay
  • Low balance/Likely to pay
  • Low balance/Less likely to pay

 Having a plan for each of these buckets is the first step toward ensuring each type of account is resolved in a timely manner. Keep in mind that all accounts are worth some kind of communication. Stratification simply means applying a communication plan uniquely tailored to the likely financial situation of each risk category.

 Inevitably several questions will arise when developing these classifications:

  • Which patients need a phone call on day one?
  • Which patients will pay in-full after only a letter?
  • Which patients need written communication and when?
  • At what point do I follow up on an account that I’ve already spoken with?
  • If I have a bad address, is it appropriate to request a skip trace on this account?
  • Which accounts will likely need financial assistance and/or a retroactive Medicaid eligibility application?

 Without having insight into a patient’s ability to pay, a patient accounts professional will develop contact strategies based on incomplete information and assumptions, which can lead to wasted time and inefficient use of resources. Having a well-rounded and detailed strategy for handling different accounts puts the time and talent of your collections team to the best use possible.

 2. Give patients a multitude of options and incentives

It is no surprise that patients are incurring out-of-pocket costs that are beyond their ability to pay in full. They want and need choices. Options like prompt-pay discounts, short-term interest free payment arrangements (think “same as cash”), and extended payment plans that carry interest all provide incentives for patients to make paying their hospital bill a priority. Additionally, a hospital must have a well-advertised and well-administered financial assistance application process. No patient who may qualify for full or partial charity should fall through the cracks. This is where an outsourced Medicaid eligibility vendor can help.

3. Adopt technology to stay one step ahead

The beauty of limitation is the ability to create technological solutions in the face of challenges. Technology exists to give your patients still more payment options and allow you to stay one step ahead. Investing in an online payment portal, for example, allows patients to pay in a manner that’s convenient for them, to receive immediate and timely statement notifications by text or email, and to have additional payment options. The automation associated with payment portal technology will also cut employee costs and save you valuable time.

4. Never stop analyzing

Adopt Key Performance Indicators (KPIs) for cash collection and commit to analyze and refine your self-pay payment processes continuously. This will also help you make sure patients who are eventually sent to collections are truly those who choose not to pay— not people who slipped through communication cracks. Conduct periodic audits to determine whether your self-pay payment processes are appropriately segmenting patients on their likelihood to pay. Consistent and continuous analyzation of your processes, your communication, and the efficiency of your staff will accurately pinpoint the things that work, the things that don’t work, and where your organization can improve.


Resolving patient accounts is a complicated and time-consuming enterprise that requires a considerable amount of forethought and strategy. However, with the right plan in place (or the right RCM outsourcing solution on your side), you’ll be well on your way to resolving accounts and ensuring patient satisfaction in the process.

 

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