Three steps to optimizing collections and avoiding patient payment pitfalls

Jeff Wood 2011
Jeff Wood, Vice President of Product Management, Navicure

Patient payment responsibility is increasing at a rapid pace: the average out-of-pocket cost per patient rose almost 255 percent during the last 10 years according to the Kaiser Family Foundation [i]. As a result, many healthcare organizations are starting to re-engineer or even re-imagine all of their processes from scheduling, to check out and billing follow-up, in order to keep pace with what patients need to pay for their care. At a minimum, patients have more questions about their higher financial responsibilities and generally want conveniences such as easy-to-use online payment options.

Whether you are just starting to update processes or are looking to fine-tune, here are three ways to respond to changing patient needs while optimizing payment collections.  

1. Educate staff and build consensus for a new patient collections model

Healthcare leaders understand their organizations can no longer remain financially healthy if they write off uncollected patient payments, but creating the necessary change can be difficult. As you develop new processes and implement new technology, it’s important to educate your staff and build consensus for these changes. First, your team needs education regarding why you’re making the changes and how critical patient payments are to your organization’s viability. Next, the team needs targeted training regarding how their processes will change and how to handle the new scenarios they’ll encounter.

As you implement training, front-office staff is especially important. They’re now on the front lines of patient collections and will be presenting estimates, reviewing patient responsibility and taking payments. In many cases, these tasks are much different than anything they’ve been asked to do before, and as a result, they may be uncomfortable and unsure. Before launching new processes, write scripts for your front-office staff and then hold a dress rehearsal to role-play the common scenarios they’ll experience prior to and at time of service.

 2. Use a card-on-file solution to speed your time to payment

Ten years ago, many patients may have been uncomfortable providing a credit card number to be automatically charged when patient responsibility was determined. Now, with many consumers providing credit cards for monthly bill payments in other areas of life, they may actually prefer putting a securely stored credit card on file at their healthcare provider’s office versus receiving paper statements via mail.

By asking patients for credit or debit card information while they’re interacting with your staff at time of care, you’ll be able to shorten days in A/R and reduce the cost and effort to get paid because you already have their method of payment. A credit card on file patient payment solution works because it enables organizations to automatically secure payments once third-party payer information is captured. Post-service payments are notoriously difficult to collect because it usually puts the burden on the patient, but this new approach helps you collect before getting to this phase. Patients also appreciate knowing the organization will make a safe and secure payment in a pre-approved but also accurate amount, because the charge occurs after the patient’s insurance has been processed during claims adjudication.

3. Leverage the full value of eStatements

Porter Research’s Healthcare Organizations + Patient Payments survey found an overwhelming majority of respondents (75 percent) who send their patients electronic statements would recommend it to a peer. However, a majority of respondents (57 percent) are still not utilizing this powerful and efficient tool.[ii] In a technology-driven world, where many people already prefer to receive and pay most bills electronically, it makes sense to transition patients from paper to eStatements, in addition to offering a card-on-file solution. Whether it is a paper or electronic statement, patients can feel overwhelmed by lengthy paper statements and would prefer a single document to review all of their pertinent care and cost information. The switch to eStatements can yield substantial savings; for example, one large southeastern urology practice reduced statement costs by 75 percent by using eStatements rather than paper. This same practice has accelerated patient payments via their eStatements Pay Now link, which allowed them to collect nearly $50,000 in the first 10 weeks it was live.

A vital part of any organization’s transition to eStatements is its ability to secure patient email addresses at or prior to check-in. Update your billing policy to include the option to opt-out of eStatements and into paper, and require patients to sign it during check-in. By making eStatements the default option, you’ll cut costs while sending the message that your organization embraces technology. For example, one mid-sized northeastern orthopaedics practice now sends 28 percent fewer statements, substantially reducing their cost to collect and improving cash flow. When the cost to generate and mail a paper statement is roughly $7[iii], the savings from transitioning away from 5,403 monthly paper-based statements in Q1 to 3,867 in Q4 during the first year, are substantial. In addition to these cost savings, this same group also decreased days in A/R greater than 120 by 59 percent.

Preparing for the efficient, high-tech next generation

Although most healthcare organizations must still offer printed statements for patients who opt-in, the industry is quickly evolving to a more efficient and high-tech patient payment world. As healthcare applies the relevant payment strategies from industries such as banking and finance, we can stay true to what healthcare needs – while also continuing to be proactive and avoid payment pitfalls.

[i] 2015 Employer Health Benefits Survey, Kaiser Family Foundation, 2015, accessible at

[ii] Survey Results: Healthcare Organizations + Patient Payments, Porter Research and Navicure, 2016, accessible at

[iii] “Collecting Patient Payment during Scheduling”:

billing, collections, eStatements, Navicure, payment solution, Porter Research’s Healthcare Organizations + Patient Payments survey


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