Patient Collection Strategies: Improving Your Revenue Management


February 4th, 2021 -
Andrew Fearnley
/ 7 Min Read

Copay collection and other aspects of patient collection strategies have taken a top priority in the revenue management of practices across the United States. Over the past several years, deductibles and healthcare insurance premiums have risen dramatically. Patients are increasingly paying more out-of-pocket than ever before for their medical services. While 92% of the population had insurance in 2019, the cost to patients continued to skyrocket. 

Tool: Check if your EMR has the BEST PRACTICES list for collecting payment upfront for all practices.

For practices, the collection process has to be handled expertly and efficiently. Many practices struggle with various strategies to bridge this collection gap. In the old model of billing, healthcare organizations routinely billed insurance carriers first. Billing for patients was after the visit. This model worked earlier because a bulk of the revenue cycle management was covered via insurance payments and government entities, such as Medicare. Patient payment accounted for a relatively small percentage of the yearly revenue at that time. 

Patient responsibility has been on the rise for several years. From 2012 to 2017, patient payments rose by 88% in hospital revenues and this trend continues. For your practice, developing solid patient collection strategies that meet the clinics’ financial needs while catering to the patient’s budgetary requirements is essential. This has been the crux of the issue. Many patients simply can’t afford to pay large bills upfront. While organizations are concerned about their patient’s continued care, they also need to maintain the revenue cycle management process. There are excellent strategies that your practice can employ to prioritize the patient’s needs and your RCM requirements. 

Also Read – How Your Practice Can Benefit from a Patient Collections Service

Tools: Utilize eligibility feature to check benefits, refer to patient outstanding balance reports and analyze copay/deductible deficit report.

Suggest using a flat fee for patients who have deductibles, such as $50 per office visit and $100 per procedure.

Patient Collection Strategies for Your Practice

There are several considerations with patient payments. In the last year, telemedicine options have increased dramatically. Virtual visits may change your usual patient payment procedures to accommodate for the fact that the patient is not physically present to provide payment. This means more than simply switching to an online or phone payment model. Patients may still need help to manage their payments, so the practice needs to be flexible in creating options for patients in these circumstances.

Note: Provide an option for the patient to pay on the portal prior to the telemedicine visit. This improves the process for practices because it eliminates the need to follow up for payment.

There are some excellent tips from the AMA on collecting patient payments through point of care payments and billing after visit options. The following strategies can help your practice improve patient payment compliance:

Develop a flat fee payment method. For patients who have deductibles, develop a flat fee schedule so that they’re paying a portion of their responsibility in advance. A schedule might look like $50 per office visit and $100 per procedure.

Assess your revenue cycle management. This is first and foremost. In order to develop a good strategy for patient payments, you need to know how well your office is currently performing. Start with an audit of your current process. To judge the success and failure of your current process, analyze your outstanding balance along with the percentage of payments made annually.

Tools: For collecting payments upfront, check the patient’s outstanding balance at check-in/front desk, oversee patient appointment reports. Check patient aging on the dashboard, and run the patient aging report. 

Open up a line of communication with patients. You can gather information by asking them questions when they arrive or via a short survey when they check into their patient portal. The best way to meet your patient’s needs is to know what they are. Practices often don’t ask direct questions about billing preferences and that makes them less likely to receive payment in a timely fashion. 

Find out how your patients prefer to pay, do they understand the payment process, and whether your practice is meeting their financial counseling needs?

Tool: Communicate with your patients proactively about their payment options.

Offer financial counsel. One problem for patients is the fact that they often don’t know what they will need to pay before the bill arrives. This can be an issue for practices, as well. There may be procedures that are necessary but not scheduled. That can change the cost of a visit dramatically. It’s important to maintain good communication with your patient to help them understand current bills and develop a payment schedule when necessary. 

Tools: Utilize the patient’s benefits print outs and come up with a payment plan 

Help patients understand insurance coverage. Healthcare insurance is not always the easiest thing to understand, even for medical professionals. Imagine how confusing it is for the patients sometimes. While this may seem outside the scope of your responsibility, it’s to your practice’s benefit and your patient’s to help them understand their coverage. 

TIP: Print out the eligibility details showing patients their benefits.

Make billing statements simple. The patient should easily understand their bill. Some practices make that slightly difficult and this can be hard to determine because your staff already knows what the billing means. Having an outside party look over your bill can give you a second set of eyes on whether they are easy to understand. This is especially true if patients have mentioned confusion about billing. 

TIP: Check if the format and output of the patient statement can be customized.

Stay up to date with coding requirements. Medical coding changes frequently and it’s imperative that you stay up to date because the claims cannot be processed with the wrong coding. For instance, in 2021 we’ll see an update to the evaluation and management service code.

Note: Providers should revisit fee schedules annually and check if their Revenue Cycle Management can do a proposed fee schedule analysis.

Offer payment options. Patients often have different preferences for payment. It can benefit your practice to offer a variety of payment options and allow your patient to choose the most convenient. 

TIP: Check if the format and output of the patient statement can be customized

Stay up to date with coding requirements. Medical coding changes frequently and it’s imperative that you stay up to date because the claims cannot be processed with the wrong coding. For instance, in 2021 we’ll see an update to the evaluation and management service code.

Note: Providers should revisit fee schedules annually and check if their Revenue Cycle Management can do a proposed fee schedule analysis.

Offer payment options. Patients often have different preferences for payment. It can benefit your practice to offer a variety of payment options and allow your patient to choose the most convenient. 

Patient payment responsibilities are a much larger percentage of most organization’s yearly revenue than they were five years ago. As patients continue to pay a much higher amount out-of-pocket, they have also become far more frugal about their provider choices. Many patients do research for their medical treatment in the same way that they traditionally researched large consumer purchases. Excellent patient care doesn’t end at the medical treatment. Patients also need excellent resources and communication in every aspect of the process, including billing.

Related – 3 Ways to Improve Your Revenue Cycle Management

PrognoCIS Tools for Prompt Payment and Collections Strategy

PrognoCIS delivers tools to help your practice communicate with patients to ensure they understand their payment responsibility ultimately leading to prompt payment and collections.

  • Provides Best Practices list for collecting payment upfront for all practices.
  • Offers eligibility check for benefits and outstanding balance and deficit reports to show how an upfront loss in collections upfront.
  • ·Works with Clearinghouses to provide patient estimator tools. 
  • ·Provides an option for the patient to pay on the portal prior to the telemedicine visit. This improves the workflow for practices because it eliminates the need to follow up for payment.
  • Offers a collection module to collect payment upfront
  • ·Allows you to match your office financial policy offerings.
  • ·Patient’s benefits print outs and payment plans can be tracked in PrognoCIS. 
  • Customize the format and output of the patient statement
  • ·PrognoCIS RCM can do a proposed fee schedule analysis.

PrognoCIS offers options for advance payment for telehealth services, check appointments and outstanding balances, and streamline communications with patients on their benefits. You can use PrognoCIS Revenue Cycle Management services or work with payment integration to keep patient credit cards on file for these services. If you are struggling to maintain a balance in your RCM due to patient payments, contact us today.


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