Behavioral health practices lack robust patient collections processes
Does your behavioral healthcare practice have a formal collections process in place to recover payment from insurers, payors, and patients?
Despite the impact of unpaid balances on the overall financial health of an organization, healthcare practitioners in general — and behavioral healthcare providers in particular — tend to shy away from patient collections.
Smaller, standalone, and rural clinics may lack resources, technology, and adequate staff training for the pursuit of bad debt. Providing treatment to patients with limited funds, including those whose substance abuse problems may have contributed to financial hardships, worsens the patient collections problem.
Reluctance to pursue patient debt isn’t just a problem for small providers. As many as one in four organizations lack a formal collections program for any of their payors, according to a recent Healthcare Financial Management Association (HFMA) survey of CFOs and other senior financial executives.
“That’s a significant number, indicating an industry wide issue that impacts providers of all types and all sizes,” said INFINITY Business Development Manager, Katina Gamboa Ilisirov, MSW. “And it’s an issue that providers need to address because the profitability of a practice hinges on its revenue collection, including patient debt.”
A shift to patient collections
Patient collections is a relatively new pursuit for healthcare providers, who have typically received reimbursement from private insurers and government programs such as Medicare in a straight fee-for-service model.
But, the healthcare industry is moving to new value-based reimbursement models designed to increase patient participation and lower costs. New models will set in place higher deductibles and shift more financial responsibility to patients.
“Providers are finding that collecting from the patient is costly and more time-consuming than the traditional fee-for-service models, and often results in bad debt that the provider doesn’t have adequate resources to pursue,” Ilisirov said.
The role of data and technology
The HFMA survey showed that while as many as a quarter of healthcare organizations still lack formal collections processes, they have made strides to offer more patient friendly interactions and are relying more heavily on technology and data to drive patient engagement.
“Increasing use of technology and data may also pave the way for better solutions to improve patient collections, making the experience more patient centric,” Ilisirov said.
As an example, interactive voice response (IVR) allows patients to make payments and get basic information 24/7, and automatically pulls up patient accounts so account representatives don’t have to search for records when patients call.
“But this kind of technology comes with a price tag, and the cost is still off-putting for many providers,” Ilisirov said.
“And there are additional issues with the use of technology that still need to be resolved, including outdated interfaces, lack of interoperability between systems, and inadequate data-management capacity,” she said.
Overall, healthcare organizations are getting better at leveraging technology and data analytics. Ongoing staffing shortages are expected to drive increasing automated solutions.
“Providers are evaluating the investment in technology as a solution to staffing shortages that don’t seem to be abating,” Ilsirov said. “With open positions that need filling, they’re looking at smart ways to move remaining staff around. Those solutions can include options such as investing in technology and outsourcing billing and collections.”
Best practices for patient collections
Improve your organization’s financial health with these best behavioral healthcare practices for patient collections:
1. Get paid upfront. Asking for payment when services are rendered, at the beginning of the patient encounter, has become a widely accepted practice. Your receptionist should ask patients for the co-payment as part of the check-in process. A staff member should also discuss the unpaid balance before the patient leaves.
2. Motivate and equip your staff. Discussing payment with patients can be tricky, requiring a bit of finesse. Training and role play is essential for avoiding confrontations. Your staff will feel much more comfortable addressing payment if they fully understand its importance to the viability of the practice, their jobs and their paychecks, and when they have had a little training in how to easily approach payment discussions. Some providers report that it can also be beneficial to motivate staff with rewards like earning time off or commissions for payments made on site.
3. Provide resources to help patients. Patients may be worried or stressed about their medical condition and financial anxiety can add to overall stress. Consider leveraging financial counselors and third-party resources to help patients navigate the financial process.
4. Make it easy to pay. Accept multiple forms of payment. Set up each patient’s card on file for scheduled and flexible automatic credit card and debit card payments.
5. Use electronic statements. Make it a practice to send an electronic statement to the patient as soon as they leave the office. If no payment is received by the due date, follow up with a polite email reminder that payment is due.
6. Communicate with patients. The patient’s perspective of the experience with the provider is shaped to a large degree by effective communication. Ensure front-end staff are collecting and regularly checking for all updated patient contact info; including patient phone numbers, email addresses, and mailing addresses. Use email or text to communicate appointment times, non-protected health information, or payment reminders to the patient. Activate your EMR’s patient portal for safe and secure communications so that staff can answer questions and make the overall experience a better one for the patient.
INFINITY can help
Do you have a backlog of unpaid bills? Are your claims being denied?
INFINITY’s knowledgeable team delivers top-notch revenue cycle outsourcing services for timely and optimal reimbursement. We drive your cash flow and optimize profitability, working hand in hand with the industry’s leading network of healthcare compliance experts. We can help you get paid faster, more reliably, and help boost your margins.
Use the form below to begin the conversation about improving patient collections and insulating your organization against payment-related audits.