Patients trust hospitals and doctors to care for them, and that trust should also extend to how their providers bill for their care. This only happens when the patient knows how they are being charged.There are plenty of programs and services that can add to patient bills, but only 14% of hospitals are fully compliant with price transparency rules, according to a recent report. This can be problematic because the No Surprise Act requires transparency and only requires patients to cover in-network costs. However, more than a year after the law went into effect, a large number of hospitals are still not upfront about their charges.
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Unsurprisingly, one of the top concerns for patients was their eventual cost of care. They want predictability, and rightfully so, because the cost of care can have a big impact on financial stability. With national inflation characterized by the cost of care, providers must address financial expectations early. By providing consumers with Good Faith Estimates (GFE)—a branch of the No Surprise Act—provides patients with more accurate and transparent estimates, which in turn are better protected from making ill-informed financial decisions. This will strengthen the provider’s patient base as consumers are more likely to reasonably afford care when they are aware of the cost.
For now, many healthcare providers calculate estimates using systems and technologies that simply can’t keep up with regulatory changes. Complicated payment cycles confuse patients and their providers, often leading to missed or reduced payments, and inefficiencies. This is when these issues also begin to negatively impact the financial stability of healthcare providers, necessitating a shift in the revenue cycle. Providers must address cost issues early in the patient collection workflow. By combining an end-to-end RCM transformation using artificial intelligence and machine learning tools with patient statement delivery and an online portal, simplifying patient collection from pre-visit scheduling to post-visit follow-up, enhancing transparency and compliance, creating healthcare benefits Provider, patient and payer environment.
Know the cost before receiving care
estimate 23 million Patients have collected medical debt — including 11 million patients who owe more than $2,000. Care planning is increasingly becoming an expensive household expense. In general, people usually compare prices and understand estimated costs before making a large purchase. Access to healthcare should be no different, especially as healthcare consumerism accelerates. Insurance eligibility and payment estimators enable providers to specify out-of-pocket costs at the time of scheduling. By providing patients with an estimate prior to care, all parties can better prepare and understand if any necessary assistance is needed, including payment plans.
There is always the possibility that additional charges will be allowed during treatment, but this is not something that healthcare providers can always predict. In any case, providing patients with the best knowledge about expected costs in advance is the best course of action, as it will increase point-of-service (POS) reimbursements and help reduce bad debts associated with writing off patient balances. Providers using cost estimating solutions will minimize claim denials by collecting medical eligibility verification, deductible information and co-payments, while developing strategies to best address the financial aspects of a visit before a patient visits. To achieve and maintain compliance while providing patients with the most accurate cost estimates, providers are empowered to identify patterns in patient healthcare spending with the help of secure digital patient statement delivery – enabling them to deliver what patients need flexibility.
After receiving care
Complicated payment cycles can be confusing for patients and providers, but shifting revenue cycles can help reduce the number of missed payments and keep employers in compliance with the No Surprise Act. Using a secure and convenient online portal simplifies post-patient process and communication. Since more than half of insured patients will out-of-pocket pay more than $500 a year in medical bills, workflows should be tailored while focusing on higher POS reimbursement rates. By offering patients the simplicity and flexibility of paying through multiple channels, providers can better encourage patients to reimburse after care. Eliminating unexpected costs facilitates mutual engagement and simplifies processes for both office administrators and patients.
Revenue cycle management operations leveraging the right automation and patient collection solutions can help providers better determine what patients must pay for their care, creating the transparency needed to remain compliant with the No Surprise Act. It also improved underlying processes and increased revenue, while closely monitoring the impact of risk, price, quality and reimbursement. Providing a secure and successful revenue cycle management operation that enables administrators to estimate patient liability and accept payments at any time will provide a solid foundation for optimizing patient-provider relationships.
Photo: fizkes, Getty Images
