How to Effectively Manage Patient Financial Responsibility: Before Care


Since the inception of the Affordable Care Act on March 23, 2010, the responsibility of payment on healthcare related services has shifted significantly to the private patient. Industry data suggest the patient’s responsible portion of the $1.00 of service rendered today meets or exceeds .17¢, and by the year 2020, will approach or breach .30¢. Providers are more prone today than ever to recover these patient responsible balances due to the impact they have on their organization’s cash flow.

As a revenue cycle management solutions provider, we counsel our clients on using a variety of resources to better manage patient responsible balances. Below are five guidelines that will help guide you towards effectively managing patient financial responsibility before care.

Before Care

  1. During patient scheduling, share with the patient what his or her financial responsibility might be in advance of the visit or encounter. There is a variety of payment estimators available thru PM solutions or clearinghouses that will allow the provider to give the patient of record insight into anticipated medical costs.
  2. Ineligible patient insurance coverage is one of the leading causes of payer claim rejections and denials. Source an Insurance Eligibility Verification solution that provides easy-to-read payer responses to insurance verification before service is rendered.
  3. Capture patient co-pays in advance of the service or encounter. Using resources like a payment estimator and insurance eligibility verification, the provider can collect patient responsibility during the point-of-service in advance of care.
  4. Employ a payment processing solution at the point-of-service for a patient. There are a variety of payment partners that provide access to a virtual terminal to facilitate patient payment in advance of service via ACH, eCheck, or credit card.
  5. More importantly, find a payment partner that allows your organization to store account information on file for future payments or scheduled recurring payments. All of these solutions allow your organization to provide greater payment flexibility to your patients in a PCI compliant manner.

About The Author

Bill Salm, Jr. is a thirty-three-year technology professional that has spent the last seven years educating healthcare professionals on best practices associated with revenue cycle management while employed at Etactics, Inc. as its Vice President and General Manager.