It’s a fact that healthcare organizations, particularly in the United States are facing more competition than ever before. The first and foremost motive of physicians is to enhance their reputation in the highly competitive market & attract more patients. For this purpose, they implement several strategies.
But sometimes, despite making every possible effort, healthcare practitioners don’t get the immense benefits as they expected. The reason is obvious. Healthcare experts believe that the major reason for this issue is the lack of understanding of consumers’ needs. We all know the fact that the base of every business is ‘audience needs’. Those who fail to meet the needs of their customers, fail to secure the top position in the fast pacing market. The same is true for the healthcare businesses. The overall success of the medical practice is highly dependent on the positive patient’s experience.
Here’s a question that arises; how can physicians improve their patient’s experience? Most healthcare professionals think that: offering exceptional medical aid is enough to create a loyal customer base. It’s undoubtedly the reality. But have you ever thought about the patient’s financial experience at your medical facility?
Perhaps, as a medical practitioner, you might overlook this aspect. Nevertheless, you should always keep in mind that in this challenging era, every consumer is concerned about their financial responsibilities in terms of copays, deducible, out of pocket costs. One can’t deny the fact, failure to ensure patient-friendly billing can result in dire consequences.
Moreover, in this modern era, you may all the time hear about the term ‘word of mouth marketing’. Did you know it also works in the healthcare industry? Yes, it’s true. For example, if patients leave positive feedback regarding their satisfactory financial and medical care experience in your healthcare facility. Then it will ultimately enhance your reputation. And patients might recommend you as the best healthcare service provider among their family, friends or social circle. As a result, the chances of high patient volume increase.
In this article, I am going to add some key findings of different surveys conducted by a leading payment technology company. In this way, you will become able to get deep insights that: why a patients’ financial experience & avoiding billing malpractice matters for the success of a healthcare practice?
- Approximately 79% of patients said that they choose the healthcare providers according to their medical billing and payment experiences.
- Almost 99% of the patients want transparency in medical bills. They demand the pre-service estimates of the healthcare services they are going to receive. But unfortunately, only 10% of physicians are focused on providing this level of patient satisfaction support.
- The majority of the patients prefer to get medical care services from healthcare facilities that provide flexible, quality digital payment options.
However, it has also been observed that collecting payments from patients isn’t as easy as it may seem. Healthcare providers reveal that failure to collect timely medical bills from the patients is one of the major barriers to their profitability. Have you ever thought about what are the major factors that hold consumers back from fulfilling their financial responsibilities? There are certain reasons.
The major reason behind this issue is the absence of written concise financial policies. Patients complain that the majority of medical practitioners don’t provide flexible methods for paying medical bills. More importantly, they never give a clear financial picture of the healthcare costs upfront. This ultimately results in high out of the pocket costs and surprise medical bills.
Surprise Medical Bills – A Harsh Reality?
Did your patients ever face surprise bills? How do surprise medical invoices affect your revenue collections? Which initiatives are you taking to put an end to it? These aren’t just questions. If you prepare yourself to answer these questions. Then you will become better able to know the facts associated with unexpected medical bills.
Surprise billing has become a major issue in the last few years. Patients suffer a lot due to this issue. However, federal authorities have recently introduced the ‘No Surprise Act’. Which intends to save healthcare consumers from being hit with steep out-of-network medical bills. Unexpected medical bills occur when an insured individual gets treatment from an out-of-network provider in case of a medical emergency. It can also occur in non-emergency care services.
Patients who visit the emergency room are more likely to end up with medical bills that are higher than their expectations. This situation can directly hit the affordability factor of the patients and they may show reluctance in paying their dues. However, in order to improve the quality and affordability of healthcare services. The US government has played its part and introduced the act, which will protect the patients from high copays and out of pocket expenses. Before moving ahead, let’s discuss the key provisions of the No Surprise Act.
- Bans surprise billing for emergency services. Emergency services, regardless of where they are provided, must be treated on an in-network basis without requirements for prior authorization.
- Bans high out-of-network cost-sharing for emergency and non-emergency services. Patient cost-sharing, such as co-insurance or a deductible, cannot be higher than if such services were provided by an in-network doctor, and any coinsurance or deductible must be based on in-network provider rates.
- Bans out-of-network charges for ancillary care (like an anesthesiologist or assistant surgeon) at an in-network facility in all circumstances.
- Bans other out-of-network charges without advance notice. Health care providers and facilities must provide patients with a plain-language consumer notice explaining that patient consent is required to receive care on an out-of-network basis before that provider can bill at the higher out-of-network rate.
How Can Providers Ensure Structured Payment Plans?
Every problem has a solution too. Similarly, healthcare practitioners can also meet the needs of their patients. They just have to analyze the consumers’ needs and align their physician billing services accordingly.
Adopting patient-friendly billing may sound difficult. But with a little effort, you can easily create the standards of patient-friendly medical billing. Which will ultimately result in better patient outcomes in terms of both reputation as well as revenue cycle management. Here are the following strategies that can help physicians to structure their payment plans efficiently.
1. A Keen Check
Before providing planned healthcare services. It is the responsibility of the administrative staff to make sure that patients are in-network and current with a particular insurance company. It will not only prevent the surprise medical bills but also the medical claim denials. Because lack of prior authorization and invalid insurance information is one of the major factors behind claim denials.
2. Establish Clear Financial Policies
Creating and circulating clear financial policies comprising payment plans, methods and other important aspects, is the best way to make patients aware of their obligations. It should be mandatory for the patients to read and sign the policy before receiving treatment. In this way, they will become legally responsible to pay their medical dues in a timely manner.
3. Be Upfront About Healthcare Prices
As we have already discussed, the majority of healthcare providers aren’t transparent. When it comes to providing the estimate of healthcare costs. So, don’t make this mistake. Make sure that your front desk staff give a rough estimate of the healthcare prices before providing the medical care services to the patients.
On that wise, patients will become able to make more informed decisions about whether or not they can afford the healthcare services. Additionally, due to the rising concerns of the healthcare consumers, the Centers for Medicare & Medicaid Services move a step further. And decided to impose penalties on the hospitals that will not stay compliant with the ‘Hospital Transparency Rule’. So, healthcare providers around the United States are taking initiatives to make their medical billing systems compliant with this proposed rule.
4. Prepare Comprehensive Medical Bills
Failure to understand the complicated medical bills is another major factor that holds patients back from paying their dues. Therefore, physicians should be very clear in preparing medical bills for the patients. There should be no complicated jargon or medical terminologies that aren’t common in patients. Thus for better financial outcomes, healthcare providers should pay special attention to preparing easy to understand invoices.
5. Provide Patient-Friendly Payment Options
As the latest technology rapidly transforming the healthcare industry. Particularly in this challenging era, patients are looking for more digital payment options to pay their medical bills without getting infected with the viral pandemic. So, if you are still using the orthodox payment methods i.e. paper cheque’s, cash through physical visits etc. Then stop using such methods. You should replace them with advanced digital options such as; debit/credit cards, web banking or other convenient ways. From which patients can pay their bills in an opportune manner.
Preventing surprising medical billing isn’t as easy as it may seem. In fact, the entire financial management i.e. The RCM process of your healthcare practice demands unique expertise and a considerable amount of time. Also, physician should be aware of key RCM metrics they need to judge their practices performance on. Therefore, it has become challenging for physicians to look after their finances while meeting the quality care standards. Due to these reasons, the industry experts highly recommend the assistance of outsourced billing and coding experts. Because it is the best way to save your valuable resources and discover your financial potential to its fullest.
Looking for a dedicated team to manage your physician billing & coding services? Physician Billing Company will be the wise choice for your business success. Having a wide range of experience in managing multiple medical specialties, our experts don’t let your healthcare practice suffer from financial losses. Contact us today and get the fully tailored physician billing solutions for your healthcare practice.