The wave of health care reform has led to a closer focus on the need for clear, consistent and transparent communication of patient financial information. As the responsibility for the cost of healthcare shifts back to the patient, and especially as more patients purchase insurance through health insurance marketplaces, practices need to get serious about their patient payment collection efforts.
One strategy to improve the likelihood of successful patient payment collections is to increase patient education and communication. Patients who are better informed about their financial responsibilities and benefits are more likely to pay in a timely manner.
Focus on Empathetic Communication
It’s important to provide staff with language to prepare them for the most common financial discussions with patients. As these discussions add to the complexity of the patient relationship, especially when financial concerns conflict with the recommended treatment plan, staff should be careful to treat these conversations with empathy.
Medical practice staff can practice empathetic communication by carefully listening to patients’ ideas and feelings, including those about finance, and demonstrating their understanding of the patients’ values.
Here are a few strategies physicians can train their staff on to improve their empathetic communication skills:
- “We” statements help express a sense of understanding and collaboration, such as, “Let’s see if we can find an alternative that works just as well, but is not so expensive for you.”
- “I wish” statements can demonstrate empathy and support while restating concern for the patient’s health and the importance of treatment. For example, if a patient resists a certain treatment route due to the expenses, acknowledging the wish that circumstances were different can go a long way in building trust and support.
Topics Addressed in Financial Discussions
The Healthcare Financial Management Association (HFMA) has developed “Patient Financial Communications Best Practices” for improving and standardizing how health care organizations should communicate with patients about their financial responsibilities.
Implement annual patient financial communications training for relevant staff, including best practices, suggested language to use and financial assistance policies. Best practices address typical elements of patient financial discussions, including:
Provision of care
Patients should be informed that their ability to pay won’t interfere with treatment of any emergency medical conditions. Uninsured patients should also be informed that the goal of collecting information is to identify payment solutions or financial assistance options.
Across all care settings, develop clear public policies on how to interact with patients who have prior balances and are undergoing elective or nonelective procedures. For non-elective services, patients should be informed that their ability to resolve any prior balances or their share of the services they are currently receiving won’t affect the care they receive.
For elective services, however, patients must make satisfactory payment arrangements before receiving care. Those with prior balances should be informed if your policies regarding prior balances mean the service will be deferred.
Tell patients about the types of providers who typically participate in a service (for example, pathologists, surgeons and anesthesiologists) and furnish a written list of provider types upon request. Patients should be informed that actual costs may vary from estimates depending on services actually performed, whether the provider performing the service is in or out of network with the patient’s insurance company, and timing issues related to other payments that could affect their deductibles. Patient share discussions shouldn’t interfere with care and should focus on patient education.
You should discuss the services that led to the prior balance and provide a written list if requested.
Balance resolution discussions are reserved for prior balances being pursued for collection. Inform the patient of the timing of collection activity and ask how the patient would like to resolve the balance for the current service and any prior balance. If appropriate, ask the patient if he or she would like to receive information about payment options and any supportive financial assistance programs. You can also proactively attempt to resolve the prior balance through insurance and financial assistance programs.
Beyond the Bottom Line
The HFMA’s best practices also include general advice for financial discussions — such as compassion, patient advocacy and education — and measurement criteria for evaluating the effectiveness of your patient financial communications. Although all of the practices are voluntary, compliance can help boost patient satisfaction while improving your practice’s financial health.