Navigating the Patient Financial Journey

Point of Service Collections are not just about collecting dollars, but a critical piece of the patient financial journey, where patients can learn more about their insurance benefits and financial liabilities. This is information patients want to know when they are engaging in healthcare.  

  • 90% of patients consider pre-care price estimates to be moderately to extremely important (Source: Advisory Board’s 2018 Consumer Financial Survey) 
  • 88% of patients want to know their payment responsibility up front (Source: Ins tamed, Trends in Healthcare Payments Ninth Annual Report) 

It’s imperative that healthcare representatives are prepared to have these discussions in an informative and empathic manner. The following are three quick tips to consistently make your patient financial journey a success: 

1. Set Expectations for Staff + Patients 

Healthcare is complicated and expensive. Patients do not always understand the nuances of insurance, how estimates are created or that they could receive multiple statements. Staff should be well versed in explaining benefits and informing patients on what comes next.

Often, healthcare representatives have knowledge that is specific to their own department. Outlining the flow of the patient financial journey helps staff understand how they can affect the patient experience across the continuum of care while improving point of service collections. It also gives associates the information they need to effectively convey these steps to the patient. 

Providing patients with collateral that is bright and easy to understand provides a high-level look at what to expect from a financial perspective. It is a great resource to get the financial conversation started and can be used online and/or as a handout. We recommend making the information available in multiple formats to appeal to a wider audience. 

2. Be Price Transparent 

Patients have a “consumer mindset” and they do shop for healthcare. Let’s make the patient financial journey as easy as possible by following the CMS requirement that took effect on January 1, 2021. Price transparency allows patients to be more informed regarding financial liability by making prices for items and services readily available. Put your healthcare system at the top of their list by making price transparency part of your brand. Ensure your published price menu or estimation tool is easy to find, easy to use and accurate. Keep in mind your Patient Access and Pre-Access associates should also know where to find this tool, how to use it and how to troubleshoot errors if a patient encounters challenges while using it.  

3. Be Consistent 

One of the biggest challenges organizations face regarding the patient financial journey is the lack of consistency. Patients are not consistently educated regarding their financial responsibility nor do organizations consistently collect their amount due. 

Use every resource available to ensure patients are informed that payment is expected before or at the time of service. Communicate through Pre-Access interactions, physician outreach, marketing collateral, websites and digital signage. 

Be sure to educate your teams across the continuum of care about how these efforts support the financial integrity of the organization. Staff should be comfortable educating patients about the organization’s credit and collection policy in addition to presenting the payment hierarchy. They should offer prompt pay discounts (if available), payment plans or financial assistance to best serve the needs of the patient. Ensure your team is consistent and set them up for success by auditing their process and removing any barriers that may keep them from having an empathic and educational financial discussion. 

Key Takeaways

The financial journey of our patients can be complicated, but it doesn’t have to be. 

Patients want to be informed of their financial responsibility and healthcare teams should be prepared to guide them. Set the course for a positive experience by using this marketing collateral to communicate expectations, become educated on your own organization’s price transparency tool and encourage consistency in education and point of service collections today. These three steps will go a long way in helping your patients and staff navigate the financial journey together.  

At Ensemble Health Partners, we help providers manage complex payer regulations and adapt to evolving trends by empowering them with the data and operational expertise they need to remain compliant, avoid lost revenue and continue to deliver on their missions of providing quality care to their communities. 
Tap into the power of over 7,100 certified healthcare revenue cycle experts today by emailing [email protected]

These materials are for general informational purposes only. These materials do not, and are not intended to, constitute legal or compliance advice, and you should not act or refrain from acting based on any information provided in these materials. Please consult with your own legal counsel or compliance professional regards specific legal or compliance questions you have.