Co-Pays and the Wild West

healthcare co-pays patient engagement

Reading about the struggles some healthcare organizations’ experience collecting upfront payments reminds me of the Wild West. New settlers arrive to the landscape and run like maniacs to stake their claim. It’s chaotic, disorganized and the strongest survive. The weak find themselves in a shootout at the OK Corral!

The Affordable Care Act brought many new settlers to the landscape. The ensuing chaos from the “claim staking” left many organizations feeling like they had just been a shootout with Doc Holiday. Those who are surviving and thriving have called upon Wyatt Earp to keep the peace in the bank.

A recent study shows that 74% of you aren’t prepared for the increased number of patients knocking at your door, which means you stand to lose 74% of your potential payments. Litmos Healthcare could be your Huckleberry!

As things morph and change, so much will be tied back to patient engagement, which starts with your patient access staff. With 15.5 million new patients are enrolled in plans where patient responsibility is at an all-time high and projected to keep growing, how will you stake your claim? Change is in the wind… or is it?

In every facet of our lives we have accepted change. The cell phone, tablet, DVR, and electric cars, many of us couldn’t even imagine these things 30 years ago. However, one arena that in many cases has stayed the same is healthcare. Sure, it once worked; so did my answering machine, but I certainly didn’t keep it.

Financial conversations are always the most difficult. Healthcare is in a tough spot—you’re faced with someone who is sick or hurt and needs your services, which you provide and often times without payment. What’s the compromise?

The most successful organizations have a rigorous process of patient verification prior to the visit. If done correctly, verification is completed when the initial appointment is set. By doing this you achieve two things, transparency regarding patient responsibility and creating a revenue safety net for your organization. Nevertheless, this will only work if the expectations are first set within your patient access staff and it becomes their responsibility to ensure this knowledge trickles down to your customers.

Analyzing your policies and procedures is an important step; it’s imperative to remember that in this new landscape, patient engagements starts with setting the appointment and does not end until the last penny is collected. Ensuring your staff is consistently following the same set of guidelines across your organization, will reset patient expectations and create transparency between your staff and your customers. Arm your patients with the knowledge of payment expectation at time of service; no one likes an expensive surprise.

Offer flexible options and utilize the technology available. It’s ideal to collect payments at point-of-service and in a perfect world you would create every dollar at check-in, but what is your process if you don’t? Not only should your staff have a process for collecting unpaid balances, this expectation should be set with your customers as well. Online payment portals are efficient and utilizing the automatic payment reminders is an easy way to be the squeaky wagon wheel. Accounts that have a higher percentage for payment are more profitable than bad debt, but does your staff know how to make this distinction? And if they do, how are they scoring these various accounts? Staff education is a small initial investment, but has the propensity for an enormous ROI.

Most Americans wouldn’t walk into a Best Buy, grab a TV and yell, “Claimed!” and walk out. Why would you allow your patients to do the same?