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The Importance of Up-Front Patient Payments

By: Nextech | January 13th, 2015

The Importance of Up-Front Patient Payments Blog Feature

Upfront PaymentsWe've posted previously about the benefits of e-eligibility services for specialists. The core reason for adopting an e-eligibility service is that it enables a practice to communicate accurately to patients, prior to administering care, their responsibility for the cost of care. Having that determined early on paves the way for collecting up-front patient payments – a practice steadily gaining momentum as patients take a more active role in paying for their healthcare.

The latest figures show that patients continue to assume an increasing share of their own healthcare costs in the form of increasing plan deductibles. The Kaiser Family Foundation recently reported that upwards of four in 10 workers with employer-sponsored health plans must now satisfy a deductible of at least $1,000 – with many workers looking at deductibles significantly above average. High deductibles are even more prevalent on the health insurance exchanges where, according to The Heritage Foundation, the deductible for most plans is more than twice that of employer-sponsored plans.

This matters to providers because the shift of insurance risk to patients also increases risk in provider revenue streams; we all know how much harder it can be to collect from an individual than from a health plan. As specialists whose practices involve primarily self-pay patients have also long known, up-front collection is key to maximizing patient payments.

Ways to make up-front collections easier include:

1. Always identify patient responsibilities well in advance.

An e-eligibility service can work wonders at streamlining this process verses the interruptive, time-consuming method of calling insurance companies for over-the-phone information.

2. Be prepared to explain. 

handsHaving information is one thing; it’s also important to communicate it effectively, and it’s tremendously helpful to have front-desk staff who are knowledgeable about plan structures and adept at explaining them in basic terms. Many patients don’t fully understand the insurance-speak of their health plans, and will be appreciative of assistance

3. Begin revenue cycle management at the front desk.

With information in hand, and having explained it to the patient, complete the process by asking patients how they wish to pay. There’s no need to be reticent; any unwelcome information will come at some point, and most people prefer knowing ahead to getting surprises later.

All of this considered, best-practice details for up-front patient collections depend on the specialty and the culture of the practice itself. Regardless of whether a practice pursues across-the-board upfront payments, it’s important for each practice to establish a policy regarding payments and the handling of unpaid balances, and to make that information readily available. Because in the end, an informed patient is a better patient, in matters of finance as well as in health.