Payment conversations can be challenging, but they also represent an important opportunity to provide valuable help and improve the patient financial experience. No one likes receiving surprise bills or feeling unprepared to provide payment. When providers help patients understand their financial obligations clearly — and offer options to help fit payments into their monthly budget — they can help improve access to care. This can empower patients while allowing the provider to stand out.
Nick Mattia, general manager of healthcare specialties for CareCredit, addresses five questions that can help hospitals and healthcare organizations make the most of the opportunity to talk with patients about payments.
Question: What foundational work should providers complete before having payment conversations with patients?
Nick Mattia: Before providers can have payment conversations with patients, they need to have payment conversations with staff. Providers may not be fully aware of what's working well or recognize key opportunities to improve. It's important for them to seek input from all staff and encourage open and honest feedback. These questions can help hospitals and healthcare organizations assess their current state:
- Are patients confused about what they owe or surprised by larger balances?
- Is it a struggle to collect payment at time of service? What about balances due?
- Why may staff members be unclear when to request payment or uncomfortable discussing financial matters?
- What are the opportunities to create consistent habits and actions among staff members?
The answers to these questions can help identify any issues to address and guide the creation of patient-centric financial policies and processes, which will become the roadmap for staff to have successful financial conversations with patients.
Q: How should policies and procedures be implemented?
NM: Policies and procedures can only be effective if the affected individuals are fully aware of them. Organizations need to communicate any policy changes to staff, patients and other stakeholders they work with on a regular basis.
In addition to written documentation, in-person conversations with staff can be helpful when introducing new policies. Providers should be open to productive dialogue, but they also need to set clear expectations. Change may not be easy, but it is often necessary, and providers should commit to supporting the transition with training and tools for staff.
Providers will also need to determine how to communicate these changes to patients. Think about all of the patient communication channels — web, email, letters, text messages, healthcare apps, and office materials — and customize messaging for each channel so the information can be easily understood. It's important to educate patients so they are clear on a provider's expectations and their obligations.
Q: Payment conversations can be hard. How should organizations prepare staff to discuss financial matters with patients?
NM: Practice, practice, practice. Organizations should provide staff with opportunities to build their skills through practice. This can help them become comfortable and confident when communicating payment information with patients.
Delivering basic staff training can help drive clarity and consistency and it's another great way to build their confidence. Training can be simple, as long as it is focused and clear. Periodically repeat training to reinforce good habits, correct misunderstandings, give participants an opportunity to share observations and ideas and bring new team members up to speed.
There are simple tools that can be developed to help staff remember what actions they need to take — things like checklists, step-by-step instructions, acronyms and rhymes. Develop a survey to allow patients to give their feedback about their experience. Ask them about things they would like to improve. Review their feedback regularly and communicate any changes that are made as a result of their input. When people see that their feedback is taken seriously, they can gain trust in the organization.
Q: What makes for a successful payment conversation with patients?
NM: Paying out-of-pocket medical expenses can be a challenge — in fact, 40 percent of Americans would have to borrow or sell something to cover an unexpected expense of $400 or more.[i] No one wants to deal with surprise bills, delayed treatment, or other stressful scenarios. It's important to have the payment conversation before treatment to help patients understand what they owe and what payment and financing options are available — whether it's a payment plan or a health and wellness credit card like CareCredit. When reviewing treatment plans, include cost estimates and insight into what insurance typically covers. By prioritizing payment conversations and cost estimations prior to care, it can take the guess work out of the patient experience, help patients build trust in their provider, and help them move forward with care.
Q: How can staff focus on patient-centric solutions when the news is less than desirable?
NM: One thought is to focus on providing some options. When patients feel like they have the power to control the outcome, they can shift their mindset to solutions rather than problems and can be empowered within their financial experience. Staff members should be prepared to respond supportively when tough questions arise or by offering multiple ways to provide assistance (e.g., recommend solutions, share materials, refer to third-party resources). Financial options can include paying over time, making online or mobile payments or adding new payment methods like the CareCredit credit card.
With a third-party payment solution like the CareCredit credit card, organizations can offer their patients another option to pay for out-of-pocket medical expenses. Patients can pay over time, making it easier to fit care into their monthly budget.* At the same time, providers can devote less time to collecting payment — and focus more on delivering the best possible care to their patients.
Providers can offer a differentiating patient financial experience by helping patients view their spending as an investment in their own health and wellness. Helping patients understand their financial responsibilities, including co-pays and deductibles, is an opportunity for providers to stand out. Patient care is no longer just about clinical outcomes — it includes helping patients plan and manage their financial obligations and the options hospitals and healthcare organizations provide to make payments easier.
In the end, sharing information, advice and potential solutions to help patients understand their financial obligations upfront and manage their healthcare spending is valuable. Honest, timely conversations about financial matters can help patients feel invested in their own care and empowered to make the right choices for their health and wellness, working with providers who want the same thing — the ability to move forward with care without delay, achieve the best possible outcomes and do so in a way that is financially sustainable.
*Subject to credit approval. Minimum monthly payments required. See carecredit.com for details.
[i] Board of Governors of the Federal Reserve System, Report on the Economic Well-Being of U.S. Households in 2017, May 2018.
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