Give patients a sense of urgency

It's a good reason to collect upfront

Many patients tell registrars at Abilene, TX-based Hendrick Medical Center, "Just bill me later," or, "I'll make payment arrangements after my insurance has been billed."

The patient is more apt to pay for services up front if they are aware of all the options available to them, says admissions supervisor Berdia Thompson.

"It instills a sense of responsibility in them to get their bill completely paid when they have started the process up front," she says. "It could also alleviate unnecessary follow-up on the part of the business office."

However, registrars are unable to offer payment plans to patients at this time, Thompson says. "Time, training, and needed information are obstacles to this," she says.

Extensive assessments of patient financial records are needed at time of admission to appropriately determine correct payment options, she explains, and arranging payment plans up front possibly could create longer wait times for the patient. "There is a sense of urgency when dealing with patient care. Time is of the essence when registering patients," she says. "Keeping patients satisfied is also critical."

More motivation at POS

The average reimbursement for every $1 billed by the hospital is only 38 cents, and failing to collect upfront decreases cash on hand and increases days in accounts receivable, adds Thompson.

"Patients are more motivated to pay for care at or before the time of service," she says. "We want an opportunity to offer financial assistance to those who need it."

Expensive surgeries leave some patients with a high balance even if they do have insurance, adds Thompson. Hendrick's registrars offer patients these payment options:

• If self-pay patients pay 50% of the estimated procedure charge upfront, the remaining balance is written off. If the self-pay patient's bill is $100, for instance, they pay $50 upfront and the remaining $50 is written off. "There is potential for high dollar accounts to be written off," Thompson acknowledges. "But normally, if a self-pay patient is coming in for a $50,000 procedure, the chances of them having $25,000 upfront are slim to none."

• Unexpected or additional charges accumulated during patient's surgical admission are adjusted on the final bill, to offer as much assistance as possible to the patient.

• If insured patients pay 50% of the estimated procedure charge, then they receive 50% off of their final bill.

If the insured patient's bill is $100, they pay $50 upfront and then get 50% off their final bill, so instead of getting another bill for $50, they get a bill for $25, explains Thompson.

If an insured patient comes in for services and pays nothing upfront, there is typically no discount offered after insurance has paid their portion, she adds. "We just bill for the remaining balance," says Thompson. "At least with the insured, the insurance is paying part of their bill, so there is a chance of some reimbursement there."

• If a self-pay or insured patient cannot pay 50% of the estimated procedure charge, then registrars ask for 33% of the amount upfront, and the remaining balance can be set up for payment arrangements through the business office.

"They have the appropriate information in which to better make decisions regarding payment plans, such as income matrix and patient financial records," Thompson explains.