Patient billing in the era of COVID-19: How providers can take an empathetic approach to collections


Before the arrival of COVID-19, patients in the U.S. were already experiencing rising out-of-pocket costs, putting added pressure on providers to improve collections. Now, with high levels of unemployment and intensifying margin pressure for health systems, transactional interactions between healthcare organizations and patients are poised to become more fraught than ever.

Amid these circumstances, it's important for healthcare organizations to help patients navigate financial difficulties and take an empathetic approach to patient billing. Here April Wilson, vice president of analytics for the revenue cycle technology provider RevSpring, details how hospitals should approach patient financial interactions amid the COVID-19 crisis. 

Question: Prior to COVID-19, patients' rising out-of-pocket responsibility for care was creating a challenge for health systems. How will the economic fallout related to the pandemic exacerbate this challenge? 

April Wilson: Giving patients a sense of control over their financial situation is going to be more important than ever. Most hospitals and health systems offer patients multiple repayment options (payment plans, discounts, full financial assistance, etc.), but those options aren't always clearly or consistently communicated in standard patient communications. For example, payment plans may be a footnote on the back of the bill, not enabled on the patient payment portal, and not mentioned in an inbound phone tree. It's time for health providers to let patients know what options they have to work with in a time where all of us feel a lack of control over what each day will bring. Not only will this approach likely increase payment rates, but it also builds brand loyalty and customer satisfaction.

Q: Amid current levels of economic difficulty, how can hospitals and health systems strike a balance between prioritizing their own fiscal health and bringing empathy to their financial interactions with patients? 

AW: Hospitals should use whatever tools they have available to assess the financial health of the patient — whether that's a traditional propensity to pay score or a more situational tool like our Financial Distress Indicator. It's vital to consistently screen all patients for financial status prior to sending them to any extraordinary collections action and leveraging that information on each and every financial communication to ensure the patient hears one voice from you regarding their financial obligation.

Q: What types of tools can hospitals use to better understand their patients' financial standing? 

AW: As mentioned above, there are propensity to pay scores, financial assistance pre-screening, Medicaid eligibility tools, as well as other tools like we've created here at RevSpring like the Fit the Payment to the Patient model or the Financial Distress Indicator. Outside of scoring and statistical tools being used on the back end of the revenue cycle, front-end processes can benefit as well. For example, if we know a patient is likely to qualify for financial assistance, why not print a pre-filled financial assistance application and have a patient counselor work with the patient on-site prior to discharge?

Q: How should this knowledge of patients' financial standing change the billing process? 

AW: On the smallest level, it should drive empathetic conversations consistently. At a higher-level, given that it may take the world longer to return to pre-COVID normal, hospitals may want to revisit and revamp their Financial Assistance Policy to account for higher unemployment levels domestically.

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