Self-pay balances, which include uninsured patients as well as the Patient Balance After Insurance (PBAI), are rising in direct connection to high deductible insurance plans, from 8% of total bill responsibility in the first quarter of 2012 to 12.2% in the first quarter of 2017. This is according to a TransUnion Healthcare study, which also included the following powerful information:

“While some hospitals are improving their profitability via cost cutting, new research also shows that optimizing revenue cycle procedures may be of even greater benefit. In 2018, cutting costs was the highest priority for 63% of hospital C-suite executives, according to a Premier survey. Yet, a recent Advisory Board study indicated that the typical 350-bed hospital may be leaving $22 million on the table by focusing on cutting costs over optimizing their revenue cycle.”

Collecting on self-pay balances can be a costly headache and struggle for many healthcare providers, but it is imperative to maintaining a healthy revenue cycle. We recommend being proactive; by combining early engagement, efficient processes, cutting-edge technology and strong patient advocacy you can increase your collection percentages on the way to optimizing your bottom line.

Finding Success in Collecting Self-Pay Balances with Effective Communication

Barring drastic and unforeseen changes to the industry, self-pay is set to be a permanent fixture due to uninsured patients and high deductibles. It is important that you develop a plan that includes the following to help keep up with self-pay accounts:

  • The ability to reach out to patients via phone, email and text messages. When requesting the information from the patient, be sure to ask them which contact method they prefer and then follow through on it with every contact.
  • Determine who will handle self-pay balances: your staff or outsourcing to a vendor? Outsourcing is becoming a very viable option that has proven successful for many healthcare organizations.
  • Most importantly, engage with the patient early in the process and, upon contact, use effective communication to set expectations and achieve your goal of collecting self-pay balances.

Key Communication Strategies

The first step in building a relationship with the self-pay patient is to develop a successful communication strategy so you can educate the patient without sounding cold, demanding or confrontational. Clear, concise communication with the patient can greatly increase the chances of them paying off their balance – below are five communication strategies you should use with your patients:

  • Greet them in a pleasant manner and be sympathetic to their situation. Remember, it is harder for a patient to be standoffish or mean if you show compassion and understanding. You want to make a good first impression and establish why you are contacting them.
  • Give the patient your undivided attention. Do not answer other calls or texts, stare at a computer, talk to coworkers, read anything or allow any other distractions to sidetrack you while talking to a patient (either in-person or on the phone). Patients appreciate someone who is completely focused on their needs.
  • Approach every interaction with a kind, positive attitude. Your personality must come across as that of a caring person who enjoys their job and genuinely wants to assist the patient in paying off their balance.
  • Actively listen to the patient. If you or anyone associated with your organization has made a mistake, take ownership at once and look to proactively resolve the situation. You must never be dismissive or omit key information, even if the information isn’t what the patient wants to hear.
  • Outline a plan that allows the patient to successfully pay off their balance without experiencing financial hardship. Follow-up regularly with the patient about their payment plan and its status via their preferred method of contact of phone, email or text.

Communication Tips to Help Increase Your Chances of Collecting Self-Pay Balances

Becoming a master communicator is not difficult. Simply put, you must care about the patient (and their problems) enough to help find a solution that benefits both the patient and your organization. Here are a few other pointers that can help you out when speaking with patients about their outstanding self-pay balance:

  • Listen. Give the patient time to outline their thoughts and feelings after you have established why you are calling.
  • Always show courtesy by thanking the patient for calling or coming in.
  • Use the patient’s name to create a more personal experience and build camaraderie.
  • If necessary, ask questions so you are completely sure of what the patient is trying to tell you.
  • Explain that you are there to help them pay their balance and answer any questions they have.
  • Always make sure the patient’s records clearly show what transpired. We highly suggest voice-recording your calls for quality assurance, while making sure to disclose that they are recorded during your initial greeting on every call.

Dealing with Difficult People

Most patients genuinely want to work with you to fulfill their financial obligation. Occasionally you may come across a patient who simply isn’t very agreeable. Remember that emotions run high when finances are involved and that people react to the stress brought on by those emotions differently. Here are a few tips on how to deal with a difficult patient who has an outstanding self-pay balance:

Consistency is key. Chances are they are trying to rattle you or get you off-topic. Do not veer away from the issue at hand or cede control of the conversation.
Ignore any personal attacks or judgments. Such statements have no tangible relation to the conversation and could be an attempt to bait you into a combative state. Remind yourself that the patient is stressed out and possibly desperate. Do not allow their behavior to affect the goal of the interaction, instead firmly and politely direct the conversation back to their account resolution.

Listen to the patient and their complaints, sometimes that is all a difficult person wants.

Try your best to identify with the patient’s feelings or problem so you can offer your unique insight and helpful assistance.

Create a Plan to Improve Your Process

As we said, most patients want to pay off their balance – they just need to understand their options. Use the communication strategies above to learn more about each patient’s unique situation and then use that to create a plan to allow them to pay their outstanding balance.
It is also important to use these interactions to create an internal plan that monitors the success rate of collecting these balances. Whether you handle them internally or utilize a vendor, you should have a plan in place to measure, meet and adjust your approach on a regular basis so you can make the necessary adjustments that will increase effectiveness.

  1. Measure – Develop metrics/KPI’s and regularly assess your performance against these standards to ensure optimization
  2. Meet – Meet with the team(s) involved to address current measurements and potential variables (What’s working? What isn’t?)
  3. Adjust – Tweak areas where performance is unsatisfactory or where problems arise (continue to fill in gaps as they are discovered to ensure optimized performance)

In the current healthcare marketplace, having the ability to work with self-pay patients to help them fulfill their outstanding balance is a necessity, including several options for repayment. Maintaining the flexibility to adapt to the perpetual evolution of the industry is vital in optimizing the self-pay face of your revenue cycle, as well as your revenue cycle in its entirety. If you would like to learn more about how to improve your revenue cycle and facilitating positive experiences for your patients, contact RevCycle today.