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Communication leads to patient friendly billing

MGMA Stat - April 4, 2017

Business Strategy

Financial Management

Operations Management

Revenue Cycle

Customer satisfaction has emerged as a key component in the Patient Protection and Affordable Care Act’s (ACA) overall push to improve healthcare quality as well as in the Centers for Medicare & Medicaid Services’ (CMS) Accountable Care Organization quality measurements and PQRS

Beyond supporting these reform-driven programs, positive customer experience scores generate dividends in their own right. The continued growth of high-deductible health plans means that consumers increasingly are shopping for care based on both cost and perceived value.  

As a result, a positive billing experience can generate word-of-mouth referrals and positive customer feedback on social media sites. Significantly, a 2013 survey conducted by Connance found that 88% of patients with highly positive billing experiences would recommend a hospital to friends.  

As patient financial responsibilities increase due to high-deductible plans, strengthening effective patient communications also can translate into accelerated cash flow. That means reduced days in accounts receivable, reduced collection expense and less bad debt. According to a 2014 survey by TransUnion, 75% of responding patients stated that pretreatment estimates of out-of-pocket costs would improve their ability to pay for healthcare.

Transparency is key

Effective communications about a patient’s financial obligations — provided both before and after the episode of care — are at the heart of a customer-friendly billing process. 

Organizations should make every effort to develop a system that can give patients an accurate estimate of their total out-of-pocket expense at the time of registration or procedure check-in. Patients who may have difficulty immediately paying their entire balance should be given the opportunity to make installment payments over time.

Additionally, statements submitted after care should be clearly written and concise. Whenever possible, the balances due from all providers involved in a care event should be consolidated into a single, easily understood statement. 

While many organizations may not yet be sufficiently integrated to offer this service, they should nonetheless work with their care partners to determine how such a statement could be produced. A consolidated statement is critical since multiple bills for what the patient rightly views as a single episode of care can confuse and frustrate customers, which can then lead to slow or no pay.

Patient-friendly billing can be further enhanced by providing a dedicated customer service contact for patient questions about billing issues. The ability for patients to connect with a specific individual familiar with all financial aspects of their care should help reduce consumer frustration and ill will. This level of service can be taken a step further if the billing representative offers to contact insurance providers, healthcare providers, healthcare facilities or government agencies on the patient’s behalf.  

Best practices from remote call centers

Since telephone conversations are the primary method for communicating with patients about financial matters, setting the groundwork for a positive phone experience from the consumer’s perspective is critical. In fact, a study by Frost & Sullivan Research suggests that being on hold for an extended period of time is one of the primary causes of customer dissatisfaction. Moreover, it can take only two negative phone experiences for a consumer to develop a diminished opinion of the service provider. 

To meet the challenge of prompt, personable and knowledgeable communications, organizations may wish to contract with a dedicated, outsourced call center. Call centers focused specifically on revenue cycle issues can provide detailed information regarding copays, dates of service and amounts due, and also work with patients to develop workable plans for paying down balances. Additionally, qualified centers offer a scalable solution that can be ramped up as patient volume increases. 

Creating a positive feedback loop

As a patient’s healthcare financial obligations increase, their interactions with billing personnel carry an ever-greater weight. For many, perceptions formed during these encounters can have a major, if not decisive impact on the way the overall organization is viewed. 

For that reason, providers must work to develop truly customer-friendly billing services. By reducing wait times; empowering dedicated, knowledgeable personnel; offering payment flexibility; and creating easy-to-understand statements, providers will foster loyalty and goodwill. 

These positive feelings not only improve the likelihood of return business, but also boost the prospect of referrals and beneficial social media reviews. Affirmative patient feedback, in turn, supports quality scores that can produce performance bonuses. 

Reasonable billing procedures and accessible, respectful billing personnel can help strengthen cash flow, reduce collection costs and cut bad debt. All told, patient-friendly billing is a positive feedback loop that, once in place, can continue to generate key benefits for both consumers and healthcare organizations for years to come.  

Why it matters

Patient billing traditionally hasn’t been a focal point for customer service efforts in healthcare. But that’s changing today as organizations pursue the benefits of a more patient-friendly billing experience. 

Improving the patient side of revenue cycle management can strengthen customer satisfaction, contribute to performance bonuses, increase loyalty and generate new referrals. It can also reduce bad debt by improving the odds that self-pay balances will be collected in a timely fashion. 

Randy Blue, MED
Regional Director, West


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