Self-pay collections are challenging for healthcare organizations of all shapes and sizes, but particularly for mid-size providers. Caught in an awkward middle ground, these organizations are often too large to operate with the agility and personal touch of small clinics, but too small to leverage the economies of scale available to large health systems. Revenue cycle managers must find the balance between operational efficiency, patient-centered services and financial constraints.
With limited staff and resources, many mid-size hospitals feel like they’re fighting an uphill battle to maintain cash flow and patient satisfaction as they contend with increasingly complex billing and insurance protocols. Implementing self-pay collections strategies tailored to mid-sized healthcare organizations can boost efficiency, reduce bad debt and create smoother patient billing processes. This article looks at practical strategies to help bring more dollars in the door without compromising the patient experience.
Importance of effective self-pay collections in the mid-sized market
Like other markets, mid-size providers are squeezed by self-pay collections on two fronts – the hospital’s financial health and patient satisfaction. Finding the right collections strategy is vital to protect this “double bottom line.”
Financially, failure to collect on bills seriously hurts cash flow. Unlike larger hospitals that might have more resources or smaller practices with fewer expenses, mid-size facilities often operate on tighter margins. Inefficient collections processes lead providers to risk revenue loss, which leads to cuts in services, staff and the ability to invest in new tech.
At the same time, the way hospitals handle billing and collections plays a major role in how patients feel about their overall healthcare experience. Confusing bills or aggressive collections tactics can damage trust. An effective self-pay collections strategy that makes payments easy, straightforward and flexible contributes to a positive patient experience and will pay dividends in the long run.
How to improve self-pay patient collections for mid-size hospitals and facilities
Here is a breakdown of some key approaches and tools that can be adapted to suit the specific needs of mid-size providers and make billing and collections more efficient, patient-friendly and cost-effective:
1. Automate as much as possible
One of the fastest ways to make better use of resources is with automation. Why have staff spend hours sending out bills and payment reminders by hand when this can be done automatically? Automated collections tools can also send email and text reminders to patients, set up auto-pay options, and guide patients to appropriate payment plans. Automatic alerts for overdue accounts can be used to help staff focus their limited time on high-value activities. This saves time, reduces errors and creates seamless patient experiences.
Read more: Maximize patient collections with automated technology
2. Segment and conquer collections
Every patient’s financial situation is different, so why handle their accounts in the same way? Segmentation divides patients into groups based on their payment behaviors, financial situations and balance size so that providers can tailor their approach.
Collections Optimization Managerscreens and segments self-pay accounts to scrub accounts that need special handling (like bankruptcy, deceased status, Medicaid and charity) and focus on patients most likely to pay. Accounts are given a segment code based on the patient’s propensity to pay, which then informs how the account is managed. For example, those who typically pay on time can get a simple text reminder, while those with larger balances or financial difficulties may need a more flexible payment plan. This solution can also be used with Patient Financial Clearance to create individualized payment plans for patients who may not qualify for charity care.
A targeted approach to self-pay billing strategies for mid-sized healthcare facilities increases the chances of successful payments.
3. Implement interactive voice response (IVR)
IVR systems allow patients to get important payment information through an automated phone system, without needing to talk to someone. Patients can receive automated voice messages or call in and follow prompts to pay their bills over the phone. Not only does this give patients far more flexibility to pay when convenient for them, but it also reduces the workload on staff, who don’t have to handle so many incoming calls.
Experian Health’s cloud-based dialing platform, PatientDial, helps patients clear their bills quickly and conveniently, with minimal input from staff. In a single year, this tool helped clients collect over $50 million in self-pay collections and save 900,000 labor hours that would have been spent dialing manually.
4. Work with a dedicated collections consultant
Bringing in a collections expert gives patient finance teams targeted support to improve collections rates while maintaining a positive patient experience. Clients who use Collections Optimization Manager get dedicated support from experienced revenue cycle consultants who can recommend the most appropriate collections strategies, evaluate opportunities to improve performance, and oversee scenarios to test and adopt new approaches.
Some providers may find it more efficient to manage collections in-house, while others benefit from outsourcing to a specialist third party. Experian Health offers collections solutions to both, enabling mid-sized providers to choose the best fit. Collections Optimization consultants provide personalized attention and customized workflows tailored to the organization’s needs, whether they’re using Epic, Oracle, Meditech or other electronic health record platforms.
Integrating patient-friendly billing practices
Whatever the strategy, maintaining a positive patient-provider relationship through patient-friendly billing is essential. For example:
- Simplifying billing statements and using clear language reduces confusion and helps patients understand what they owe
- Running coverage discovery checks and offering upfront patient payment estimates gives patients greater clarity about their financial obligations
- Setting up automated reminders nudges patients to pay on time
- Highlighting available payment plans gives patients manageable options to reduce the risk of unpaid balances.
Experian Health’s data insights allow providers to better understand patients and develop strategies for proactive outreach before debts become unmanageable. Collection Optimization Manager’s segmentation model draws together credit, behavior and demographic data, incorporating socio-economic modeling and income estimations to build a complete picture of each patient. Unlike traditional segmentation models that rely solely on payment history, the CO model includes estimated household size, income and federal poverty line analytics to generate a meaningful score without needing additional data.
Automated communications such as PatientTextandPatientDial make the billing and payment process less intrusive. Combining convenience and personalization builds trust and improves collections while supporting a more compassionate patient experience.
Enhancing revenue for mid-sized medical groups with improved self-pay collections
Going back to that “double bottom line,” Judy Wirtz, Senior Analytics Consultant at Experian Health, explains how Experian’s collections toolkit helps mid-sized organizations boost financial performance while maintaining a positive patient experience:
“Boosting self-pay collections for mid-size healthcare organizations doesn’t have to be daunting,” she says. “Our goal is to simplify collections while keeping the patient experience front and center. We use industry-leading data, smart segmentation and dedicated support to help organizations customize their strategies based on their unique patient mix and resources. Other tools fill in different pieces of the collections puzzle, but Collections Optimization Manager is the only one to give providers the full picture. Our clients have seen an impressive 9:1 return on investment, so we’re confident this approach makes a real difference.”
Wirtz suggests that those who’d like to learn more about Collections Optimization Manager should watch Experian Health’s recent webinar with Wooster Community Hospital. The hospital used CO to collect $3.8 million in patient balances.
Find out more about how Collections Optimization Manager boosts self-pay collections for mid-size healthcare organizations.
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