Healthcare consumerism is on the rise as high-deductible insurance plans lead to greater cost sharing by patients. Insurance companies are incenting consumers to consider the value of their healthcare when making choices, not just the cost. And proactive medical practices are looking for every opportunity to make even incremental improvements in the end-to-end experience an office visit provides.
As recent data demonstrates, a strong place to start is the after-visit process, where mishandling of billing and revenue cycle management can ruin a great clinical episode. In the 2019 Healthcare Consumer Study* from Cedar and Survata, over 1600 patients who had visited a physician and paid a medical bill in the previous 12 months were interviewed. Nearly half, 45%, named the part of the healthcare process from billing through insurance follow-up as the worst part of their experience. Plainly, the patient financial journey needs improvement.
Though the Cedar study dealt heavily with the process of paying a healthcare bill and the lack of flexibility and online technology prevalent in other industries, an absence of transparency was the key takeaway. Sixty percent of study respondents had tried to get an estimate of what their visit would cost, and only one-half of those were successful. Patients want, and deserve, a reasonably accurate estimate of what they’ll owe after a visit. The ability to give that to them, even with caveats, must be a priority.
How can your medical practice respond? A variety of processes have been created to develop estimates, based on practice specialties and services. Technology also is available to assist. If your practice is just starting this effort, some retooling of functions and related employees will be required. In particular, employees who develop and explain your estimates to patients will require deep insurance knowledge, “hospitality” skills and communication skills.
What else can make a measurable difference? Flawless intake work, including correct demographic and insurance entry into the billing system, along with the same level of insurance knowledge and communication skills for relevant employees. Demographic and insurance enrollment errors are the number one reason claims fail on the front end, thus slowing down the billing process and your revenue management cycle. The faster a claim processes, the more likely the estimate you’ve given up front will prove accurate, because claims from other providers will not process in front of yours and change your numbers.
Don’t assume that patients with billing issues automatically assign blame to insurers. One in three patients in the Cedar study felt that providers haven’t done enough to improve the patient billing process, and 38% were frustrated with the lack of customer support for billing questions. One easy way for practices to improve the patient experience is signing off on notes timely so claims can be billed quickly. In addition to supporting more accurate estimates, speed in initial claim processing allows problem claims to be corrected/appealed quickly and any patient balance to be billed quickly, versus billing months later as is often the case.
Another patient satisfaction improvement opportunity is to outsource the post-visit process. Physician Interlink has the right number of staff and the experience level to manage the increasingly complex changes in the healthcare revenue cycle. We allow you to focus on your core competency, minimize patient frustration with the insurance process, and keep your practice stable and healthy.
*The 2019 Healthcare Consumer Study from Cedar and Survata interviewed 1607 respondents online between August 27 and September 1, 2019.