Using patient outreach to collect more payments

How hospitals can use technology-enabled communications to engage patients and drive payments

Collecting self-pay revenues from patients is often difficult for hospitals and healthcare systems. In recent years, it has become even more challenging because the number of patients with high-deductible healthcare plans has increased. Not only are there more out-of-pocket revenue dollars for hospitals to recover now that more patients have high-deductible plans, but there are also more patients who delay payments. According to a West report, 56 percent of patients in the United States delay paying medical bills at least some of the time. To help reduce late payments and bad debt that threatens financial stability, healthcare organizations can put strategies in place that make it easier to collect out-of-pocket patient payments. One of those strategies is to utilize technology-enabled communications to drive payment resolution.

A West survey revealed that nearly four in five patients (79%) feel affordability is the biggest problem with healthcare in America. Two-thirds (67%) of patients say their financial situation makes it difficult to pay their medical bills on time. As a result, 12 percent of patients say their payments are “always” delayed, and another 16 percent admit they “frequently” delay paying their medical bills.

The financial strain patients feel is shared by hospitals. Bloomberg reported that healthcare bankruptcy filings more than tripled in 2017. Uncollected self-pay revenues are one of several things threatening the financial viability of hospitals.

Eighty-five percent of patients feel there are strategies healthcare teams can use to encourage and help them pay their medical bills on time. Hospitals have opportunities to support patients and drive payments by leveraging the same technology that is used to deliver appointment reminders. Hospitals and health systems that make outreach a priority can engage patients in conversations about healthcare costs, improve transparency, remind patients about payment deadlines and follow-up when payments are late.

Some hospitals have started using technology-enabled communications to help collect out-of-pocket payments, but the majority of hospitals could leverage their patient communication technology more effectively.

Cost Transparency
Healthcare consumers typically are unaware of the price of the services they are purchasing. Three in four patients (75%) say they do not know the cost of healthcare services until they receive a bill. Although patients and providers both view cost as a top healthcare issue, the cost of care is often not discussed until the point when patients are billed.

Even when patients know that a bill from their hospital is on the way, planning for the expense is difficult because patients do not know what insurance will cover. Thirty percent of patients delay bill payments because they are confused about what insurance covers and what they need to pay. To make things more clear, hospitals can send patients messages before billing them to let them know they may need to pay for some or all of their medical expenses out-of-pocket. Sending this type of notification improves transparency and helps patients plan for medical expenses.

Hospitals already send automated appointment reminders and other information before scheduled procedures. Healthcare teams can add to these efforts and send patients reminders to bring their insurance card, let them know they will have a co-payment due upon arrival, or alert patients that they may be responsible for out-of-pocket costs. These messages can be automated and sent just like appointment reminder messages. By sending voice messages, emails or text messages to share cost information, hospitals can give patients earlier notice of their financial obligations, and ensure patients have time to plan for healthcare expenses. This can help reduce the likelihood of payment delays.

Proactive Payment Reminders
Outreach shouldn’t end once a bill is sent to a patient. Another point when hospitals may want to contact patients is just prior to payment deadlines. If a payment deadline is approaching and a patient has not paid their bill, staff can easily send an automated payment reminder voice message, text or email. Other industries use these types of messages to remind consumers and encourage them to pay bills. But healthcare has been slower to adopt payment reminder messages. Although many providers already have technology in place to automate payment reminders, just four in ten healthcare providers (41%) currently use their appointment reminder technology to prompt patients to pay bills. More than one-third of patients admit that it is difficult for them to remember to pay their bills on time. These patients are prime candidates for proactive payment deadline reminders. Hospitals that introduce payment reminders may see an uptick in on-time payments.

Past-Due Payment Messages
When a patient fails to pay a bill, hospital staff can either reach out and encourage them to make a payment, or wait and hope the patient takes action. Surprisingly, many hospitals choose to wait, or simply mail patients second and third notices. Less than a third of hospitals contact patients by phone when they miss payments. Even fewer hospitals use automated communications—which require fewer resources and have lower costs than staff-initiated outreach—to contact patients with outstanding balances. But hospitals can see better results if they use technology-enabled communications to contact patients who have not paid their outstanding balances. Not only is sending a friendly message soon after a missed payment deadline a good reminder for patients, but if the message offers an option to instantly pay with the click of a button, the message can drive immediate payment. Many hospitals have the capacity to send past-due messages with instant payment options and could easily take advantage of this outreach opportunity.

Patients across the United States are struggling to pay their medical bills, and many are delaying payments. As long as that continues, the challenge of collecting payments and reducing bad debt will not go away. How hospitals and healthcare organizations respond to this challenge will define their financial well-being. There are many different reasons why patients do not pay bills. Those healthcare teams that take advantage of their patient communication technology and use it to help patients overcome payment obstacles will see the most success.

About the Author

Allison Hart is a regularly-published advocate for utilizing technology-enabled communications to engage and activate patients beyond the clinical setting. She leads thought leadership efforts for West’s TeleVox Solutions, promoting the idea that engaging with patients between healthcare appointments in meaningful ways will encourage and inspire them to follow and embrace treatment plans - and that activating these positive behaviors ultimately leads to better outcomes for both healthcare organizations and patients. Hart currently serves as Vice President of Marketing for TeleVox Solutions at West (, where the healthcare mission is to help organizations harness communications to expand the boundaries of where, when, and how healthcare is delivered.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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