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Payments made online have doubled over the past two years at Cincinnati (OH) Children’s Hospital Medical Center, reports Christopher Lah, senior director of revenue cycle customer service.
"About 15.5% of total dollars collected went through the portal," says Lah. "The portal is starting to have a significant impact on both our copay collections and other out-of-pocket expenses." With 27,919 online payments made in 2014, $5.3 million was collected, with an average of $193 paid per transaction.
Marie-Louise Stanek, a consultant with Atlanta-based Accenture Health Practice, says, "We are definitely seeing healthcare organizations moving toward implementing patient portals for patient collections, both pre-service and post service."
Patients want more visibility into what they owe. Don Wright, senior vice president of operations at The Outsource Group, a St. Louis, MO, consulting firm specializing in the healthcare revenue cycle, says, "Hospitals have finally figured out that consumers want to be able to resolve their accounts electronically."
However, payment portals can’t answer complex questions regarding patient out-of-pocket expense. "The billing process in healthcare, right now, is probably the most complicated there is," Wright acknowledges. Most patients know their deductible amount, but they can’t determine how much of it has been satisfied to date. Nor do they understand the contract the hospital has with specific providers that can affect the patient’s out-of-pocket liability.
Wright recommends these practices:
• offering patients a link to chat with a live person to resolve more complex questions;
• listing frequently asked questions on the portal that tell patients what specific questions to ask their insurer about their out-of-pocket expenses.
"If patients are not asking the right questions, payers won’t necessarily willfully withhold information, but they will protect their best interest," explains Wright.
Lah says collecting patient balances online "is very much hitting our radar screen. We are constantly figuring out how to address this better."
Several years ago, the hospital’s payment portal was getting fewer users each year because it wasn’t user-friendly. "Many patients simply want to get in there, make one payment, and be done with it," says Lah. Once the facility implemented a new portal (developed by Franklin, TN-based Passport, a provider of technology for hospitals and healthcare providers), enrollment increased fivefold. "We had dipped all the way down to 3,000 people in the old portal, but it’s well over 15,000 now, and climbing," says Lah.
Before the new portal was developed, a customer focus group was held. "We learned that it had to be more than just a payment portal," says Lah. Families wanted these things:
the ability to set up a payment plan;
answers to two questions: "How do I pay?" and "How do I get help paying this bill?"
simple language, such as "Make a Payment Here" or "Getting Help with Your Bill."
"People like the word help’ better than "financial assistance.’ The minute you put financial assistance’ out there, you start spooking people," says Lah. "Some are reluctant to apply for charity assistance."
Patients at Oakwood Healthcare in Dearborn, MI, are given the option to pay online, but patient access staff members still spend much time educating patients on their out-of-pocket liabilities, says Michelle Bidoul, manager of financial clearance.
"Because the balance of a patient bill includes so many variables, it can be a challenge for a patient to substantiate what they owe," she explains.
If family members think they owe only a copay and discovers they have a $5,000 deductible, they typically want to know who they can call immediately to discuss it.
"An efficient portal can help provide this information," says Lah. "However, if you are hoping the portal can eliminate phone calls purely by listing assistance options, you are setting yourself up for failure."
While the portal does direct the initial call more effectively, it often does not eliminate the call from occurring. "No matter what you try to answer on the portal, individuals are going to come up with other questions," Lah explains. He recommends these practices:
Display payment portals prominently on the website’s front page.
Paying bills is one of the primary reasons customers log into a hospital website, notes Lah.
"The minute people click on it, it has to become the yellow brick road’ that shows them how to get to all the different options they want to explore to help resolve their debt," he says.
Be sure portals don’t appear complicated.
Participants in one of the hospital’s focus groups requested simple pull-down boxes. "Too often when you go in to make your payment, you end up lost in a vacuum," says Lah. "The navigation needs to be Fisher Price-like."
Strive to make the hospital’s payment portal more like those offered by other industries.
"You can’t narrow your scope to healthcare only," says Lah, noting that American Express won J. D. Power’s Best in Class award for having an effective and friendly portal. "That’s what you should be using as a comparison."
Consider offering prompt pay discounts via the portal to increase cash collections and reduce bad debt.
Something as simple as Click here to inquire about a 10% discount,’ will drive interest," says Lah.
Michelle Bidoul, Manager, Financial Clearance, Oakwood Healthcare, Dearborn, MI. Phone: (313) 982-5317. Email: firstname.lastname@example.org.
Christopher Lah, Senior Director, Revenue Cycle Customer Service, Cincinnati (OH) Children’s Hospital Medical Center. Phone: (513) 636-8904. Email: Chris.Lah@cchmc.org.