As hospitals acquire practices, bridging payments for customers is key

Healthcare is a $4 trillion market, which makes up 18 percent of the U.S. gross domestic product and consumer payments are expected to be worth approximately $600 billion by 2019.

Simultaneously, consumers have seen debt at $13 trillion, a record amount. Healthcare economics have put a similar squeeze on patients as well, since they often rely on insurers to pay the bill. Today, approximately 75 million Americans have turned to high deductible healthcare plans, the average of which is $1,500 plus limits on percentages paid for many medical procedures. Americans, already stretched by debt levels, must now struggle with those higher-than-usual medical expenses, as well.

Out-of-pocket costs are rising for patients due to lack of, or reduction in, insurance coverage. Patients may turn down treatment simply because they can’t afford it. For others, if they do accept treatment, they may have difficulty paying for it, resulting in a collection issue for the practice. To maintain financial viability, providers must adopt new procedures to avoid major write-offs for uncollected fees. By including patients in financial discussions, understanding how payments work and setting up card-on-file, practices can collect more payments and maintain good relations with their patients. Even as reimbursement changes have shifted the payment conversation between doctors and patients, practices must also wrestle with managing data tied to those very same patients.
Thousands of independent practices are being acquired by hospital systems on an annual basis due to consolidation. The hospitals want buying power gleaned through scale, and as many as two-thirds of providers are tied to hospitals. These practices are urged to sell due to an increasingly stiffer regulatory environment. Now, with data flowing electronically among different technology platforms, hospitals must bridge these different payment solutions since they now will be under one roof.

Patients expect the payment experience to be a seamless one, just like in retail. They want to log into their accounts online through portals, pay statements via phone and expect to have recurring payment plans. With a changing workflow, there are four different areas to consider. The first is eligibility. Does the patient have insurance? If so, what are the terms of that policy? The second component is estimation, which involves determining how much the patient must pay for the service. The third component is capacity of that patient to pay. Lastly, there’s the actual collection of payments. The fourth point is where payments technology comes into play through the practice management system. A wealth of data flows through that system, increasing visibility from patient information to payments information and initiating better decision-making.

In the past, credit card information would have been taken at a single terminal. With a signed receipt in hand, providers would then go back into the patient’s ledger and key in that transaction. The new process comes across an integrated credit card terminal, which posts automatically back to the ledger. Providers have found it necessary to ask for payment upfront or a guarantee of that payment from the insured. They are also creating various vehicles through which they collect those payments. Consider a kiosk installed within a practice that is used for check-in, and where, if a bill is outstanding, it must be paid before proceeding with that day’s appointment. Other medical reimbursement methods include payments plans and cards-on-file. For more information contact

Ben Buchanan, Director, Health Relationship Management, TSYS®

Ben Buchanan is a veteran of the healthcare industry with over 8 years of experience in account management and product management roles. In his role with TSYS he leads the team of healthcare relationship managers responsible for implementing the payments strategy within the healthcare industry. Prior to TSYS, Ben worked in multiple roles at Carolinas HealthCare System in Charlotte, North Carolina. He holds a Bachelor’s degree in Marketing from the University of North Carolina at Asheville, and a Master’s of Business Administration from Queens University of Charlotte.

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