Updated on August 2, 2024 by Jordan McGlone
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Going back 10 to 15 years to look at the old reimbursement model largely depended on governmental payers. Medicare, Medicaid, the private insurers Blue Cross, Aetna, Cigna, and United provided the majority of reimbursement to medical offices. That’s not to say that patients were completely left out of the picture; they still had to pay their copay or a small deductible, but the majority of reimbursement came from the payers themselves.
From the healthcare provider’s perspective, that represented a relatively steady income stream, and that transaction used to be more business-to-business. Medical offices could balance the books and forecast budgeting more easily than today. Properly collecting patient payments is a critical part of maintaining business continuity.
Key Takeaways
1. Effective payment collection requires training staff on courteous and professional communication, understanding patient financial situations, and explaining charges and payment plans.
2. Secure payment handling is crucial, necessitating regular staff training on HIPAA regulations, secure payment processing procedures, and recognizing phishing and social engineering attacks.
3. PatientCalls offers HIPAA-compliant medical answering services that also cover processing payment options for your company.
What Are the Best Practices for Collecting Patient Payments?
Your patients’ well-being should always remain an important part of your practice, but your healthcare practice is also a business. That’s why every medical office needs to reevaluate its strategies for collecting patient payments and do this sooner rather than later.
Below are seven effective practices for collecting patient payments.
Build a Business-Minded Environment
Profitability for a healthcare practice is everyone’s issue, not just the provider’s or office manager’s. The front-desk staff, back-office staff, nurses, medical providers, and everyone in between need to be on board with the practice’s goals and understand these trends. This is because everyone will play a part in this process moving forward.
Educate Office Staff on How to Discuss Payment
At the checkout desk, patients experience a range of emotions—from relief to anxiety—which are tied to their experience with the healthcare provider. So, it’s important that admin staff approach patients with courtesy and professionalism.
They should express understanding of the patient’s financial situation and also be informed enough to explain charges and discuss payment plan options.
Train Staff on How to Collect Payments Securely
Regular staff training and awareness programs are essential for maintaining HIPAA compliance and ensuring secure payment handling. Staff should be educated on the latest HIPAA regulations, secure payment processing procedures, and how to handle sensitive information.
Additionally, employees should be trained to recognize and respond to phishing and social engineering attacks, which are common methods used by cybercriminals to gain unauthorized access to payment information.
Communicate in Advance with Patients
In terms of healthcare literacy, the average patient doesn’t know what a deductible is or what the difference is between a copay and coinsurance. That’s why communicating to patients about visits up front gives the patient the chance to answer some of their questions, call their insurance company, and understand why certain things are covered or not.
Using tools like email, text messages, and reminder phone calls about what the visit is expected to look like from a financial perspective can go a long way towards disarming patients before they are ultimately asked to pay the bill.
Collect Payments While the Patient Is on Site
Collecting copays upfront is extremely important in the overall patient financial process, rather than waiting for the bill to go to collections. There are now some handy patient estimation tools that can provide an idea of their actual out-of-pocket costs and help authorize payments up-front.
Accept Multiple Forms of Payment
Arming your admin staff with as many tools as possible to capture patient payments is fundamental to financial success. The average U.S. consumer uses at least three different methods to pay monthly bills so payment processing should be available in-person and online.
Establish a Secure Payment Channel
Secure payment channels are essential for protecting patient data during transactions. This involves using encrypted payment gateways, which ensure that any data transmitted between the patient and the payment processor is secure and unreadable by unauthorized parties.
Additionally, secure point-of-sale terminals should be used to safeguard data during in-person transactions. Implementing tokenization, which replaces sensitive payment data with non-sensitive equivalents, further protects against data breaches by ensuring that actual payment information is never stored or transmitted.
Secure payment collection is essential for healthcare organizations to maintain patient trust and comply with HIPAA regulations, ensuring the protection of sensitive financial information. It also prevents data breaches and fraud, safeguarding the organization’s financial integrity and reputation.
Tips on How to Collect Money From Patients
Collecting payments for patient balances is a combination of following rules and practicing empathy, all while maintaining security. To help you streamline the process, add these practices to your patient collection strategies.
- Explain payment policies upfront to ensure patients understand their financial responsibilities.
- Offer various methods like credit cards, online payments through a patient portal, and payment plans to provide flexibility.
- Send invoices promptly after services are rendered to avoid delays in payment.
- Use reminders via phone, email, or text for upcoming or overdue payments to keep patients informed.
- Make the payment process simple and user-friendly to encourage timely payments.
- Regularly follow up on outstanding balances to ensure they are addressed promptly.
- Offer discounts or incentives for early payments to motivate patients to pay sooner.
- Handle all payment interactions with professionalism and empathy to maintain a positive patient relationship.
- Train staff on effective payment collection techniques to ensure consistency and medical office efficiency.
- Implement a clear and fair policy for handling unpaid bills to manage and resolve outstanding payments.
To facilitate payments and other administrative tasks, partner with PatientCalls. Our medical outsourcing services can help you cover appointment scheduling, patient interviews, and medical bills. Our call center professionals can also help you streamline educating patients with patient plans that they can avail of.
Use our HIPAA-compliant medical answering service today!
Why Are Proper Patient Collections Important?
As we move towards value-based care, the billing process will be evaluated as part of the patient’s overall experience with the medical practice. The billing process occupies the last 5-10% of the care continuum.
So, an individual patient may be generally happy with the care received, with a positive check-in, great exam, and accurate diagnosis. However, if the billing process on the back end becomes burdensome and the last touch point with your practice is negative, it can affect the value associated with that service.
Impact of Value-Based Healthcare Reimbursement on Medical Offices
Over the past three to 5 years, the healthcare reimbursement model has been shifting. More and more has been transferred onto the shoulders of our patients. This change has been expedited by the focus of government insurers and some private insurers to transition 75% of reimbursement over to a value-based care model.
As a result, today’s medical office staff spends a good amount of time chasing down bills and leveraging inefficient practices to secure payments. However, with a value-based system, where the value is based on the patient’s overall experience, providers won’t get paid for that time.
At the same time, employers in the private insurance market are trying to cut costs around their benefit expenditure. We see this in the fact that only 4% were enrolled in a health plan categorized as ‘high-deductible’ in 2004, and in 2014, that number jumped to 20% with a deductible greater than $1000 for an individual or $2000 for family coverage.
For medical practices, this creates a new challenge where they are required to collect a deductible greater than $1,000, in addition to the co-pay, from most patients. In fact, collecting patient due balances has become one of the top 10 pain points for 96% of physicians, according to the Centers for Medicare and Medicaid Services.
Who Is Responsible for Collecting Patient Payments?
Having a key person responsible for collecting medical payments is crucial for healthcare organizations’ financial health and operational efficiency. This role ensures that payment processes are managed systematically, reducing the risk of revenue loss and maintaining cash flow.
In a healthcare organization, the responsibility for collecting patient payments typically falls on several key roles:
- Front Desk Staff. Responsible for collecting co-pays and initial payments at the time of service.
- Billing Department. Handles sending out invoices, managing payment plans, and following up on outstanding balances.
- Financial Counselors. Assist patients in understanding their bills, insurance coverage, and payment options.
- Accounts Receivable Team. Manages and tracks all incoming payments and outstanding accounts.
- Practice Manager or Office Manager. Oversees the entire payment collection process to ensure efficiency and compliance with policies.
- Third-Party Billing Services. Some organizations outsource their billing and payment collection to external companies specializing in medical billing.
In a complex healthcare environment, the presence of a key person in charge of payment collections helps streamline operations, ensures compliance with regulatory requirements, and ultimately supports the organization’s financial stability and growth.
What Are the Best HIPAA-Compliant Payment Processing Tools?
For secure payment processing that is also compliant with HIPAA Privacy and Security standards, financial experts in healthcare recommend the following medical billing software:
- Square. Offers a fully HIPAA-compliant free merchant account with appointment POS, free e-commerce tools, and integrations with popular EHR platforms. Square goes above and beyond HIPAA compliance for its payment processing and management software.
- PaymentCloud. Specializes in HIPAA-compliant solutions and is a good fit for telemedicine practices and high-risk healthcare providers.
- Dharma Merchant Services. This tool offers low-cost transaction fees for healthcare providers processing over $10,000/month. It is also good for nonprofits.
- Stax. An all-in-one payment processor with HIPAA-compliant software and cheap credit card processing rates for established healthcare providers.
The best HIPAA-compliant payment processing tools should have several key features, including willingness to sign a Business Associate Agreement (BAA), strong encryption and security measures, the ability to keep PHI separate from payment data, integration with existing practice management and EHR systems, and fair, transparent pricing.
While standard credit card processing may not necessitate HIPAA compliance, any system handling patient information, scheduling, and invoicing must adhere to HIPAA regulations. Utilizing a dedicated HIPAA-compliant payment processor helps healthcare practices avoid potential compliance issues and penalties.
Virtual Front Desk & On-Call Health Care Answering Services
Efficient and secure payment processing is crucial for medical practices’ financial health and operational efficiency. PatientCalls offers comprehensive HIPAA-compliant medical answering services that streamline the payment collection process while ensuring compliance with stringent privacy regulations.
Our services include phone call triage, patient reminders, pre-appointment communications, and follow-ups, all integrated with HIPAA-compliant encrypted messaging, email transmission, and data processing technology. By partnering with PatientCalls, your practice can leverage our expertise to manage payment options effectively, from collecting co-pays upfront to offering flexible payment plans and multiple payment methods.
Our staff is trained in courteous and professional communication, understanding patient financial situations, discussing payment plans, and ensuring that each patient interaction is handled empathetically and professionally. We also prioritize secure payment handling, providing regular training on the latest HIPAA regulations and payment processing procedures to protect sensitive information and prevent data breaches.
