The Provider’s Guide to Patient Responsibility

How is your practice addressing patient responsibility? Out-of-pocket costs are increasing substantially for patients. Educating patients on how much they owe out-of-pocket is important so there is no confusion as to what they are obligated to pay. However, this is not as simple as sending them a bill. Your practice needs to tailor its entire collections strategy to the patient. PRL has led the charge on helping practices address growing patient responsibility. We have written a useful 10-step guide that provides clear strategies your practice can take to adjust your payment strategy and maximize collections.

Clearly Define Patient Responsibility Upfront

Many patients are surprised to learn that insurance does not cover all their costs. As patient responsibility increases, your practice should ensure patients understand what their out-of-pocket expenses are. Provide your patients with an accurate quote for the services the practice will provide. It is also important to provide pricing differences between health plan covered services and self-pay, so the patient can choose the most cost-effective option. A clear understanding of patient responsibility upfront will save time and prevent billing disputes.

Offer Detailed Explanations for Service Charges

Patients are like consumers. They want to know what they are paying for and how much it will cost them. Be prepared to provide a line-item bill detailing each service provided and how much you charge for it. Keep in mind that there may be differences in cost between insured patients and self-pay patients. Stay up to date with your coding, as CPT codes are used for billing and can be used to generate a line-item bill. Additionally, new laws such as the No Surprises Act, require you to provide Advanced Explanation of Benefits to patients who request the document.

Educate Your Patients on Services Covered by Insurance

Health insurance plans are complicated. It is often difficult for patients to determine what services insurance will cover. Cost transparency is also a growing issue. Leverage your expertise and experience working with insurers in your network to provide patients with a clear understanding of what their plan covers. For out-of-pocket costs, help the patient determine if their payment can be applied to their deductible.

Make Patient Payment Easy and Convenient

Studies have shown patients favor using online payment portals for paying their bills. Invest in a PM system that has a portal feature where patients can pay their bill with a few clicks. Make sure the system is secure so credit card information remains protected and secure. Use paper bills with clear payment instructions with patients who are uncomfortable using an online portal. Easy billing and payment will help improve your collections rates while reducing the time it takes to receive patient payment.

Keep Credit Cards on File

Collecting credit card information will speed up patient payments. It will prevent your patients from having to constantly re-enter payment credentials every time they need to make a payment. This also allows for automatic payments to be debited to credit cards on file. That will save everyone time. Be sure to use a system that provides ample protection so credit card information remains secure.

Understand Who Your Patients Are

Your patients are not a homogenous group. Age, gender, income, and a host of other demographics can create variables in patient behavior. A method of communication or a payment option for one person may not be comfortable for another. Be sure to understand who your patients are and respond to their preferences when it comes to communication and payment. You want to communicate efficiently with your patients so they understand their payment obligations.

Focus on Communication

Reach your patients where they are and be sure to use multiple communication channels. Each patient is different and has a preferred method of communication. A combination of mail, email, text message, and phone calls should be used to ensure your patients have all the information they need to pay their bills and have their questions answered.

Be Empathetic to Those Dealing with Financial Hardship

Healthcare costs are higher than ever before. Some patients may have high balances while facing financial insecurity. This can be a serious obstacle in collecting patient payments. Use a call center staffed with customer experience specialists who talk with your patients and not to your patients. This provides an opportunity for you to clearly outline the patient’s responsibility while working with them to come up with a feasible payment plan.

Provide Affordability Options

When working with patients dealing with financial hardship, be sure to offer them affordable options. These can include flexible payment plans or incentives such as one-time discounts on high balances. This will alleviate some of the financial burdens on your patients, improve their interactions with your practice, and prompt them to pay on their outstanding balances. Utilizing payment portals and convenient payment options will help accelerate these patient responsibility collections too.

10. Choose a Qualified Partner

When it comes to patient experience, work with a partner who you trust. Be sure they have the capabilities to provide an end-to-end patient experience. You also want to confirm they share your same values and understand your practice’s financial goals. Working with a trusted partner can considerably boost your patient payments and your revenue yield.

We understand healthcare is more complicated today than ever before. Ensuring strong collection rates and protecting the integrity of your revenue is essential to your success. If you want to improve your collections and your patients’ financial experience, then consider PRL as your partner. Together, we will prepare you for the age of the new healthcare consumer and increased patient responsibility.


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