Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

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Patient Billing Challenges Revenue Cycle Management

Organizations can improve revenue cycle management by making patient billing processes more automated by using a modern payment systems.

- Patient payment and billing are significant revenue cycle management challenges that should not be ignored.  According to a recent survey conducted by Navicure, 63 percent of participants recognized that patient payment processes were “a high priority" for the healthcare revenue cycle.

Healthcare organizations will have an easier time collecting payments if they use modern, automated payment systems.

“It is important to reexamine existing workflows and processes to adopt a more effective, automated patient payments process,” the survey said.

Patient accountability was also major concern for participants, who reported having difficult time collecting payment from patients. About one-third of survey respondents (31 percent) said they struggle with patients’ inability to pay for medical bills. Additionally, 26 percent of participants experienced difficulties educating patients about their financial responsibility. A quarter of participants said slow-paying patients remain a significant challenge.

On the subject of best practices for payment processing, results varied. A majority of participants (62 percent) did not offer an electronic credit card on file. Only 35 percent of organizations had a credit card on file payment system. Of those, 64 percent would recommend it to others. Those who have implemented the system were pleased with the results so far, the survey said.  

Also, 52 percent of participants did not automate payment plans while 57 percent did not send electronic statements to patients. The participants that did use these technologies to make the billing process better thought their peers should do the same.

READ MORE: Credit Card On File Program Key To Patient Collections Success

Researchers argue that it’s helpful for organizations to have a securely stored credit card on file that can be automatically charged once a patient’s balance is determined. By doing this, organizations can reduce the time it takes to receive payments from patients.

Additionally, it’s in the best interest of healthcare organizations to have a modern payment system in place. To get paid, healthcare organizations need to make it easier for patients to pay,” the survey said. Organizations should strive to adopt more effective, automated collections processes.

“These trends are serving as a catalyst for healthcare organizations to implement patient care estimation and payment technology solutions because they can no longer afford to ignore this major threat to their revenue and reputation,” said Jim Denny, founder and CEO of Navicure.

According to the survey, healthcare organizations are taking steps to improve price transparency so patients are informed ahead of time how much they owe. Almost 60 percent of surveyed individuals claimed that they educated patients regarding their financial responsibility and about their organization’s payment policy. Additionally, 42 percent of participants stated that they always estimate the patient’s financial responsibility at the time of service.

The survey also found that only 35 percent of organization require patients to pay a partial deposit prior to service while 21 percent don't charge patients until claims are processed. Also, 26 percent of participants collect the total amount that a patient owes before they receive care or service.

READ MORE: Patient Financial Responsibility Not Owed Top Medical Debt Issue

Although a majority of participants fell short of putting several best practices for payment collection processes in place, they did follow other best practices. For example, 57 percent of respondents “always” educate patients about their financial responsibility and the organization’s payment policy. More than 50 percent of participants said their organization had technology or solutions for online bill pay. However, only 32 percent were “very satisfied” with their online bill pay, while 28 percent were “somewhat satisfied”.

Additionally, 88 percent of participants provide patients with financial estimates at the time of service. However, only 42 percent of participants stated that they “always” present an estimate, while 46 percent claimed that they “sometimes” present an estimate to patients.

“This research validates market trends where patients are responsible for an average of one-third of the healthcare costs, largely due to high-deductible health plans. Because of this, many patients are choosing providers who can estimate their cost of care at or before time of service,” Denny explained. “In addition, multiple states are requiring healthcare organizations to provide patients with healthcare cost estimates or risk fines.”

Providers typically gain a significant portion of their revenue from patients. However, this survey revealed that the patient payment revenue portion of total revenue varied widely. For 32 percent of participants, patient payment revenue was 11 to 20 percent of their total revenue. For 20 percent of participants, this form of revenue made up 21 to 30 percent of total revenue.

For this study, researchers obtained data from practice administrators, billing managers, and executives.

READ MORE: 74% of Providers See Increased Patient Financial Responsibility

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