Tag: patient responsibility

With the ability to research products, compare price information, and conduct transactions all from their mobile devices, today's consumers are more savvy than ever. They expect an unprecedented level of transparency from companies. In fact, they demand it and will easily take their money elsewhere if a company doesn't follow through. Consumers expect the same high-level transparency from healthcare providers, and the demand is growing as patients are forced to bear more out-of-pocket costs for medical care. They want to avoid surprises, such as higher-than-expected cost estimates for services or insurance that may cover only a small portion of the expense. Price transparency initiatives are becoming increasingly more important in healthcare systems, and providers must embrace new capabilities to meet patients' expectations. The old model of billing patients weeks or months after they’ve received services is no longer viable. Billing needs to move to the front of the revenue cycle management process, and a number of Experian Health's solutions are designed to help do just that. 3 tools for greater price transparency in healthcare As patients are responsible for a higher percentage of their healthcare costs, healthcare providers' financial performance depends on an optimal collections strategy that focuses on patient engagement. The advantage of patients knowing and having confidence in healthcare cost estimates makes the collections process much easier and helps drive the future revenue cycle. Here are three Experian Health solutions that can help healthcare providers improve price transparency: 1. Patient Estimates: Patient trust is built on meeting expectations. With this in mind, Experian Health's Patient Estimates tool brings accurate, upfront price transparency before or at the point of service so patients know what to expect and can confidently make decisions about their healthcare. Cost estimates are derived from numerous types of data, including a patient’s benefits information, a healthcare provider's reimbursement agreements, and payer contract rates, among others. Much of the information can be automatically populated into the system, eliminating the need to constantly update price information lists and reducing the risks of inaccurate cost estimates resulting from error. With Patient Estimates, healthcare providers can also more effectively comply with state and federal price transparency requirements. 2. Patient Statements:Accurate price information is one thing, but even if the patient’s billing statement matches the cost estimates, collections can be a challenge if the statement is hard to read or understand. Patient Statements is a communications tool that simplifies and customizes patient billing statements, complete with important, easy-to-understand updates and messages. Making billing statements straightforward for patients to manage helps healthcare providers build a stronger level of trust when it comes to payments. Personalizing the statements with marketing and educational information turns them into valuable resources that create a better overall patient engagement experience. 3. Patient Self-Service:With accurate, upfront price estimates and simple, useful bill-paying systems and statements, healthcare providers can more successfully integrate our online self-service portal. Experian Health's Patient Self-Service tool digitally delivers cost estimates and statements to patients. It also allows patients to securely make payments and conveniently schedule future appointments from their desktop or mobile devices. Patient Self-Service brings the high level of price transparency to healthcare providers that consumers now expect. This makes it more likely for patients to meet their self-pay responsibilities and return for future healthcare services. Patient Self-Service also helps healthcare providers more efficiently comply with "meaningful use" Stage 2 program requirements. The capabilities for price transparency that these solutions provide is just a small sampling of what we offer today, and we’re continuing to research and develop even more useful tools. In addition, we’ve recently launched an extensive consumer research project to better understand patients’ wants and needs. We’re excited to use these insights to continue developing solutions that help healthcare providers improve engagement with patients.

Rudyard Kipling famously wrote, “Oh, East is East, and West is West, and never the twain shall meet.” That was once true of care delivery and medical payments; they were two separate departments encountered at different stages during a physician or hospital visit, and each was siloed to the activities of the other. Today, patients are avid participants in their care and are more engaged and concerned with where their healthcare dollars are spent. With that in mind, savvy providers are collaborating with patients not only on a clinical level, but also on the financial side to better navigate their options. This new approach gives patients the power to make informed financial decisions about their care, with discussions taking place prior to treatment, rather than after when an unexpected bill or lack of understanding around financial obligations can negatively impact a patient’s overall perception of their care and the organization itself. While it’s no surprise that patients are taking on greater financial responsibility for their healthcare costs due in large part to the rapid rise of high-deductible health plans, the statistics are overwhelming. In 2006, only 55 percent of covered workers had an annual deductible, which averaged $584. In 2014, according to the Kaiser Family Foundation, that deductible has more than doubled to an average of $1,217 for 80 percent of the covered workforce. When you consider that slightly over half of covered workers have an annual out-of-pocket maximum of $3,000 or more, that creates a gap that providers can’t ignore for the sake of their fiscal health, or that of their patients. At the heart of achieving better patient engagement on the financial side is accurate, real-time information. Advanced technology gives providers the ability to provide patients with a more comprehensive picture of financial information and to present them with financial options that fit their needs. Three key steps to achieving higher payments and better patient satisfaction include: 1)    Be proactive – Talking to patients prior to receiving care not only results in higher patient engagement and satisfaction, it also substantially increases the amount providers can expect to collect. For example, showing online full-disclosure of billing data builds trust among patients. 2)    Provide accurate estimates – Patients deserve the right to make informed decisions based upon the cost of care. For example, providers should be able to quickly – and easily – review expected costs and explain insurance coverage. Offering patients tools, such as the ability to request a real-time estimate online, gives them more control over the financial side of their healthcare. 3)    Offer choices – Payment plans designed in cooperation with patients, such as the ability to set up automatic payments, not only empowers them, it improves payments and reduces administration burdens. Implementing these initiatives creates a more informed patient, which leads to a positive care experience and eases financial stressors. Patients are able to make educated choices and, if necessary, structure a payment plan that meets their needs or identify potential financial assistance programs. Providers also see benefits, such as increased patient loyalty as well as an improved revenue cycle and decreased administrative burdens when it comes to collections and follow up. Mr. East, meet Ms. West. By integrating the clinical and financial sides of healthcare, patients are more engaged with their care, leading to better health for the patient and improved financial outcomes for providers.

There aren’t too many situations in which an individual purchases a product or service, but is NOT asked to pay for it right away. Healthcare, however, is somewhat unique in that regard, often avoiding a retail-based experience where patients receive service, but pay quite some time later, whether in full or the balance. Not surprisingly, this approach often times adversely impacts healthcare organizations in many ways. Best-case scenario, patient payments, while unpredictable, are received, but not in a timely manner and after a good deal of effort on the collections staff’s part. Worst-case scenario, the organization is left holding the proverbial bag, forced to write off bad debt, when payment could have been received if handled differently. In between, there are poor cash collections, increased revenue cycle costs and lower patient satisfaction. Organizations can avoid this perfect storm with a more precise approach to optimizing patient revenue. By leveraging tools that empower and improve upfront financial counseling communication, healthcare organizations stay one step ahead by accurately predicting patient responsibility payments and enhancing pre-service collections. When fueled by data and analytics, these tools offer a powerful two-pronged approach to minimizing risk and driving revenue: Avoid patient payment delays. Without knowing what insurance companies allow, many providers postpone collections until payer reimbursement is received. Healthcare organizations should instead have access to the latest contract terms, payment rules and fee schedules in order to identify patient and payer responsibility much earlier in the revenue cycle. Increase time-of-service collections. By proactively using patient payment data and current payer contract terms to calculate the amount owed by the patient at the time of service, organizations can effectively collect either a portion or all of that payment upfront. In the end, data-driven estimates of patient payment responsibility allow healthcare organizations to capture more revenue at the right time and boost cash flow. An added bonus is enhanced patient satisfaction because there are no confusing bills or ongoing collections calls, enabling a more personal experience for the patient. Hospitals have an opportunity to use data and analytics to improve the revenue stream and patient satisfaction. Learn about how Experian Healthcare Patient Responsibility Pricer can improve your collections on the front end of the revenue cycle and enhance the overall the patient experience.