RCM tip of the day: Reduce cost to bill by segmenting patients' propensity to pay

Patients are taking on more of the healthcare cost burden as high deductibles increase in popularity. Given this trend, hospitals and health systems continuously strive to improve patient communication and collections, as well as reduce costs.

Ted Williams, principal at Payor Logic: The old adage "first to bill is first to collect" is no longer applicable in the era of growing self-pay accounts due to high-deductible health plans. With HDHPs, the responsibility for paying healthcare claims shifts from payer to patient, requiring updated billing workflows and claims prioritization practices.

One tip is to segment patients by their propensity to pay before the billing process begins. For example, if you quickly determine a patient insured under an HDHP has no financial resources, is unemployed and already in debt, you can forego sending out unnecessary bills and notices. Instead, revenue cycle staff can focus efforts on securing charity care exemptions, supplemental Medicaid or payment plan options.

Be sure to arm your billing staff with patient credit data early in the patient encounter. The sooner you determine how likely the patient is to pay your healthcare claim, the more money you save.

To learn more about how to successfully collect from patients with HDHPs, access this story from Becker's Hospital Review.

If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series.


More articles on revenue cycle management: 

CHI records $483M operating loss as labor costs grow, patient volume declines
nThrive acquires another RCM provider
Tranquilmoney named among 'most promising RCM solution providers'

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