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Why I Don’t Want to Pay My Doctor: A Patient’s Perspective

A recent visit for an annual physical left me feeling angry, cheated, and worst of all, broke. After expecting a twenty-dollar co-pay, I was shocked to hear the administrator at the front desk utter, “And, today, you owe, $275.” My eyes grew big, almost popping out of my head, “Excuse me?” I questioned. “I’m sorry; you haven’t met your deductible yet” she explained with a smile. “I’ve seen worse,” she added. I was confused and overwhelmed by the various thoughts flooding my head. Wait a minute, I have great insurance, an awesome job, and set that money aside for a fun weekend trip to Charleston, not to give to you, I thought to myself. Of course I couldn’t tell her that. I reluctantly handed over my debit card, turned around, and waited to see my doctor. I felt slighted in some way. Why didn’t someone tell me this before I booked the appointment? Why isn’t my insurance paying for this? Do I really owe that?

Surprise Bills Are the Worst Kind.

While $275 may not seem like a lot to some, it was a shock to me, and something I wasn’t prepared for. This is an all too familiar story and a large reason why medical practices need to increase patient engagement and communication amongst practitioners. It’s beneficial to set clear expectations in regards to the patient’s financial responsibility before the appointment is even scheduled. It’s vital for everyone involved – the insurance companies, the medical practice, and especially the patient to understand what is owed. Patients are consistently confused about what they owe. Last year, 42% of consumers said they were confused by the bills they received from their providers.

If I Don’t Understand, Do I Still Have to Pay It?

Who wants to pay a bill when they aren’t sure they “really” owe what is listed on that bill? A friend of mine who recently had a baby, shared that she received multiple bills from various doctors. Now, eight months later, the bills are still being altered, corrected, and worked out by her insurance company and the hospital. Meanwhile, she’s been sent to collections, and now has a healthy baby and an unhealthy financial situation. According to the Medical Billing Advocates of America, 8 out of 10 hospital bills contain mistakes.

I Have to Pay for My Dinner, But Not My Doctor?

Due to a change in FICO scoring, medical bills now weigh less on your credit score, thus patients have even less of an incentive to pay their doctors. Working for a medical billing software company has shown me how much patient debt some practices are writing off. Meanwhile, doctors are becoming banks that provide financing for patients that are trying to pay their medical bills. Sometimes it takes patients years to completely pay their doctors, while the patients who are unwilling to pay their medical bills, or just simply can’t, are written off as bad debt with little to no repercussions for lack of payment.

Give Me Options, like Paying Hospital Bills Online

I want to pay my bill, but I’d rather do it online. My phone bill, my rent, my car payment, and even my power bill get easily through my providers' online portal. Just like choosing an affordable phone plan, residence, automobile, or setting up fixed utility payments, I should be able to pay hospital bills online. I enjoy the convenience of setting up automatic payments on a schedule that I choose. Unless it’s a personalized greeting card, I absolutely hate getting mail, where most of it ends up in either the trash or the shredder. I’m not alone! 93 percent of consumers would pay online through their provider’s or a health plan website. Providers need to understand, as a patient, we need multiple payment options and most of us, would rather pay you online.

The Struggle is Real, and How Patient Payment Plans Can Help

Even with insurance, many patients are struggling to pay medical bills. The Kaiser Family Foundation reported that one-third of Americans struggle to pay their medical bills. With increases in high deductible plans, the rising costs of prescription drugs (nearly 123.7% from 2000 to 2013), and stagnating income, it’s no wonder I’m more likely to go into bankruptcy from my medical bills than by supporting my shoe fetish. High deductible plans aren’t going away. If you don’t currently have patient payment plans options for your patients, you need to. There are many great options available to help patients pay their medical bills. Practices need to start offering these options to their most difficult payers; their patients. Just be sure to vet out these programs to ensure they have your patient in mind, and won’t hit them hard with high interest fees if they default on payments. Imagine recently launched HonorCare®, a flexible, interest free option for patient payment plans. As a patient, and someone who works closely with providers and medical practices, this is a wake up call for providers to start offering patients more payment plan options, continue increasing patient engagement, and provide patients with the most accurate explanation of what they owe.

Now, let it be clear that I’m not saying it's acceptable to not pay your doctor. My goal is to provide a unique insider’s perspective from both a patient who has experienced frustrations and confusion surrounding medical bills, and as a professional, whose daily job is helping providers and medical practices with patient collections.

Reducing Denials and Increasing Patient Care

With denials rising in frequency every year, it’s important to understand where denials are coming from and how they impact your patient experience. Administrative expenses for hospitals, medical practices and health agencies are approaching $360 billion dollars a year – most of which is billing related. The typical cost of reworking a denial is $25 per claim which totals about $4500 a year if you are processing 15 denied claims per month. That seems like a surmountable gap when broken down, but almost a third of practices are processing denials manually which can be a long and costly process.

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Denials happen for a number of reasons:

  • Terminated Coverage
  • Services not covered
  • Maximum benefit for service has not been met
  • Pre-Authorization required

With the technology available, it’s surprising that benefit eligibility is still at the top of the list for payer denials. Something as simple as checking benefit coverage is still wreaking havoc in administration workflow, and with a little time and effort it can be avoided all together. What if your system had the capability to automatically detect patient coverage, eligibility and benefit deductibles?

Having a competent and knowledgeable staff running your front desk is one of the most important things you could ever put in place. The first person your patients encounter tells them everything they need to know about your practice. Is your staff friendly? Are they familiar with your system and processes? Do they provide benefit verification and estimation upfront? These are all things that can ensure a visit goes smoothly and avoids costly after appointment expenses.

Every practice wants to see their office and staff be effective and productive, but sometimes this comes at the expense of your patient’s experience. With healthcare becoming a patient and consumer centric industry, it’s important that the weight of the patient’s decision to choose you as a practitioner stays top of mind. Having a system that provides transparent pricing helps promote patient-practice communication, trust, loyalty and satisfaction.

How would your patients feel knowing what their total out of pocket expenses would be before they stepped into an exam room?
Would they feel secure in their provider experience and walk out feeling valued as a patient and not just a number?

We think they would.

This is why ImagineSoftware’s solutions all work seamlessly together to create a better patient experience for your practice. When ImagineAITM, ImagineDiscoveryTM, and HonorCare® are employed in your office your patients discover that their coverage questions have been answered before their visit begins. You have the ability to uncover missing demographic details, find missing insurance coverage, estimate patient responsibility, and offer reasonable payment plans and options to ensure that not only are the bills paid – but your patients feel taken care of long after they’ve left your office.

If you practice needs help caring for your patients, get in touch with us today. We’d love to help you find the custom solution that fits your healthcare billing needs.

Increase Patient Satisfaction with Digital Communication

Communicating with your patients is key to patient satisfaction. 89% of patients feel they do not spend adequate time with their physician during their visits which can leave them feeling disregarded and less likely to keep their doctors’ orders.

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In an era where technology is ever increasing, there are now more ways than ever to connect with your patients and continue fostering a relationship after they have left your office. Today we’re going to look at 3 ways you can improve your communication with your patients using technology.

Patient Portals

Patient portals are still a relatively new technology that provides a way for patients to book appointments, view their treatment history, pay bills and request a tele-visit directly with their provider without needing to call or come into the office.

“Having bi-directional messaging between the patient and provider, not only is convenient on both sides, but it saves an administrative burden as well,” he continued. “And being able to show that health record to the patient enhances the communication lines and provides self-service which is great for the patient and the provider.”

Overall, patients tend to like having this view of their health data when it is offered to them, and nearly 80% of patients have regular access to the internet and can use this feature. The most important thing is ensuring your patients know how to use the portal and have the opportunity to sign up on site before they leave your practice. For more information you can read this article.

Text Messages

A secure text messaging forum may be exactly what your practice needs to keep in touch with busy clients. Mary Clare Lingel, vice president of operations at Cedars-Sinai, says “We all tend to have very busy lives, especially working professionals with families. It is difficult to get on the phone with our providers during the day, so we’re looking at all ways in which we can expand access for our patients to us when they need the access.”

Cedars-Sinai has implemented WELL, a secure text messaging platform, to be able to respond to patients quickly and immediately as well as dive into conversations to answer questions quickly and efficiently. As their staff has been able to integrate the new texting platform into their staff workflows, they have seen a tremendous response from their patient base which has directly correlated to an increase in patient satisfaction.

Social Media Support Group

One of the things that providers are turning to is using social media to form virtual support groups for individuals and caregivers. Beyond giving the patients an added layer of support and comradery, nearly 60% of support group users “reported feeling reassured in their healthcare decisions” and empowered to ask their providers more detailed questions surrounding their care and treatment plans.

The internet and social media have become an integral part of our everyday lives, which has changed the way we interact with our friends and loved ones. When patients can turn part of their daily routine into something that offers a deeper level of emotional support and validation it increases communication with the provider as well as raises patient satisfaction from being part of a supportive and informative community.

Healthcare organizations with high patient satisfaction and CAHPS scores see a multitude of benefits, including higher reimbursement rates from CMS, better retention rates and assurance for the hospital staff that they have provided a positive experience for their patients. Clear and quick communication is an integral part of having a positive healthcare experience, and with the addition of a few key elements you can bring your organizational communication into a new era of patient-provider communication and satisfaction.

If your practice is in a place where it needs to increase its digital footprint, ImaginePay is great place to get started. ImaginePay offers a centralized platform to manage your client’s payments, automate payment scheduling and alleviate the administrative burden of payment tracking. Interested? Get in touch today for a quick demo.

3 Ways to Prevent Denials

When maintaining a healthy practice, it’s imperative to keep abreast of the inner workings of your office to ensure it’s running at optimum speed. One area that many providers lose consistent revenue is in their denials. Unfortunately, once a claim has been denied it only has a 35% chance of being reworked to recapture the reimbursement1, so having an actionable set of steps to help prevent denials from happening is imperative to running a healthy business.

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Preventing denials is a two-part system that works hand in hand – your front of house intake and your back of house billing. When you have knowledgeable and informative staff that manages your co-pays, insurance eligibility, and patient demographics it ensures the correct information is in your back of house billing system to run a claim through successfully. As a vitally important part of your practice, what are some steps your office managers and front of house intake specialists can take to make sure you don’t have money walking out the door?

  • 1. Be vigilant about clean registrations

What does this mean? It means that as a business owner you must empower your staff to make corrections and ask more than “Has anything changed in your insurance since the last time we saw you?” When your employees are knowledgeable about the full life cycle of a claim and all of the information that is needed to process a claim successfully it helps your entire staff take ownership of their piece of the puzzle.

Engaged and active employees also create satisfied patients who are confident in the office they have chosen to do business with. 

  • 2. Check Eligibility

It’s also essential to ensure the clinician providing care is contracted and credentialed with the exact insurance product the patient is covered by. “Most practices don’t even know precisely who they’re contracted with,” Penny Noyes, president and CEO of Health Business Navigators says. “They’re pretty confident they’re with the Blues, Aetna, et cetera, but they don’t know for sure if they’re in the HMO, PPO, Medicare Advantage, or private Medicaid products.”

Noyes recommends practices conduct a periodic review to confirm which products each clinician in the practice is linked to. It’s time well spent, regardless of how long it takes. In a small practice, this information can be gathered through one or two phone calls to each payer, she says.

Considering that 90 percent of denials are preventable, most practices can become top performers — not just for bragging rights, but also for the opportunity to gain significant revenue and increase their bottom line while reducing their bad debt.

  • 3. Ascertain Financial Responsibility

One of the most important tools you can arm your front of the house staff with is a prequalification and estimation tool. When you give your patients an estimate of what their treatment will cost it gives them the ability to plan and budget for the expense.  It also increases your patient-practice loyalty because not only are you keeping your own bottom line in check, you show care and concern about your patient’s well-being outside the confines of your office.

In tandem with a prequalification and estimation tool, giving your patients the ability to pay over time gives them more control over their finances and lowers the chance of your patients not paying their bill at all. Through our HonorCare program we have found that giving patients a payment that works on their timeline and within their budget increases the practice’s likelihood of being paid. While it may take longer for your patients to reach a zero balance, bringing some money in over a long period of time is better than not getting any money at all and having to write that patient bill off to bad debt.

Week after week we see healthcare facilities closing their doors or opening themselves up to a corporate buyout due to bad debt or outdated practices. Maintaining a healthy revenue cycle is vital to a growing and expanding healthcare organization, as well as ensuring your patients are satisfied. The key is to be knowledgeable as to what your company needs, what your patients desire, and how your staff is handling the inner workings of your practice. If you take the time to find out what tools could help your staff do their job with increased productivity, you could help your practice become more profitable.

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