How do you expect to get paid if you never discuss Patient Financial Responsibility? Providers report a significant rise in uncollected self-pay revenue in 2017 and the first two quarters of 2018, however, only 23 percent said they always discuss patient Financial responsibility when the patient is initially seen.

Healthcare organizations are struggling to collect full patient financial responsibility, especially with the rise of high-deductible health plans. Yet, a recent survey of over 230 providers and 1000 adults revealed that fewer than 36 percent of providers report ever discussing a patient’s ability to pay prior to delivering care.

The survey demonstrates that healthcare organizations are seeing uncollected self-pay revenue increase because of high-deductible health plans. About 80 percent of individuals said that affordability is their greatest challenge with healthcare, causing 56 percent to delay paying their medical bills at least some of the time.

Out of the adults who admit to delaying payment, 12 percent stated that their payments are always delayed, and another 16 percent said they frequently delay paying their medical bills.

Millennial’s are avoiding their patient financial responsibility. Millennial’s were more likely than non-millennials (70 percent versus 50 percent) to delay medical bill payments.

Patients across the age spectrum pointed to high deductibles as the top reason for uncollected self-pay revenue. Approximately 42 percent of patients stated that they avoid medical bill payments because of unexpectedly high deductibles.

According to a recent eHealth analysis of the Healthcare Marketplace during the 2017 open enrollment period, the average annual deductible was over $8,200 for a family plan, accounting for a 3 percent, or $249, increase compared to the previous year.

With high deductibles inching higher each year, 95 percent of providers acknowledged that their patients may delay paying their financial responsibility because of their financial situation.

Surveyed adults also reported other top factors causing them to avoid paying their patient financial responsibility, including:

  • Confusion about how much their insurance will cover and how much they owe (30 percent)
  • Receiving medical bills for services or items they do not think they should have to pay for (30 percent)
  • Waiting to receive the final medical bill so they are sure of the amount they owe (25 percent)
  • Unsure about what payment method to use (11 percent)

As patients report uncertainty and confusion regarding their medical bills, they also stated that they find it hard to remember to pay their financial responsibility on time. Over one-third of patients forget to submit payments and over one-half of providers recognized that patients do not pay because they forget.

Patients are turning to providers to help them pay their financial responsibility in a timely manner. Eighty-five percent said that there are strategies providers could implement to promote timely payments, such as discussing financial responsibilities.

While many providers never have patient financial responsibility discussions, about 23 percent stated that they always address a patient’s capability to afford and pay for services. Researchers advised providers to use their existing appointment reminder messages to open conversations on patient financial responsibility.

About 52 percent of practices use multiple communication methods to connect with patients about appointments, including calls, text messages, and email reminders.

Using these same communication methods, providers could remind patients about possible co-payments and out-of-pocket expenses at their upcoming appointment. The message would open discussions about patient financial responsibility prior to the office visit and allow patients to plan their payments.

Providers should also communicate cost information before sending a medical bill. Connecting with patients about healthcare costs may decrease medical billing confusion felt by 30 percent of adults and help about three-quarters of individuals who stated that they never know the actual cost of their healthcare services until they receive a bill.

While giving patients cost estimates has the potential to improve self-pay collections, less than one-quarter of providers plan to implement a price transparency tool and just 15 percent currently contact patients either by phone, text, or email to explain their medical bills.

Once medical bills are sent, providers should also use appointment reminders or other communication methods to connect with patients about due dates and missed payments. With over one-third of patients forgetting to pay their financial responsibility using payment reminders could help providers gently remind their patients.

However, only four in ten providers leverage their appointment reminder technology to remind patients to pay their bills and just 31 percent of providers call patients who have missed a payment.  Even fewer providers reported that they used automated communications, such as texts and emails, even though they tend to cost less than using staff time to place calls.

Providers are missing an opportunity to significantly boost self-pay revenue by neglecting to connect with patients about financial responsibility.  Providers can give patients full transparency with regards to their potential out of pocket expenses by utilizing our insurance verification tool.

Additionally, CarePayUSA can make that conversation extremely painless by offering patient financial tools to collect that revenue by approving up to 95% of all patients with a need to stretch their financial responsibility out over 6, 9, or 12 months interest free.

Post Written by:  Dr. Paul Burns, CMO, CarePayUSA

For more information contact one of our Specialty Market Representatives:

Dr. Paul Burns @ 303.908.4486