Consumers today manage many complex transactions digitally, from applying for home loans to buying cars. Yet getting clear information about the cost of a healthcare procedure remains challenging. Price transparency was supposed to help consumers compare costs, but many experts say the industry’s pricing structure is still too complicated for transparency to provide useful information.
Yet healthcare providers still can take advantage of automation and AI to deliver a modern financial experience. That experience will include more accurate cost estimates and guidance about payment options. It will improve access to care, while enabling providers to reduce collection time and costs and improve cash flow. Modernizing the financial experience is about more than payment: it requires a comprehensive approach that includes pre-registration activities and extending the streamlined digital experience into the point of care. Here are key best practices for accomplishing those goals.
- Engage the patient before they reach your front door. More consumers than ever are used to – and even expect — digital self-service options. Many want to engage service providers at times and places of their own choosing. Offering digital portals through which patients can complete various registration and financial tasks at their convenience makes life easier for them and for the provider. Providers may brand white-labeled portals vs. developing their own to get to market quicker and more cost efficiently.
- Take an omnichannel approach to patient communications. Depending on their ages and digital experiences, patients prefer different channels, whether text messages, email, snail mail or voice. Providers that communicate via patients’ preferred channels will engage them more effectively and see better response rates.
- Keep it digital. Enable patients to do tasks digitally, such as uploading an image of their insurance card, verifying their demographic information from an electronic medical record and using digital signatures on documents. Robotic process automation (RPA) can streamline these processes, such as by prepopulating fields with demographic data from an EMR so a patient only needs to verify the data’s accuracy. Digital also offers patients privacy as they answer screening questions that could guide them to payment options for which they may be eligible, such as Medicaid, third party benefits, COBRA, workers’ compensation or health exchange plans.
- Offer predictive, intelligent guidance to patients and provider financial representatives. Predictive AI tools and machine learning can offer appropriate payment options based on individual patient characteristics and can indicate patients likely to have difficulty financing their procedures. Those insights can help providers’ financial representatives to connect digitally to these consumers and offer restructured payment plans or financial counseling support. AI can even prompt representatives with effective language to use during interactions to gain better results.
- Include coverage verification and estimates. It’s possible today to get near real-time verification not just of a patient’s eligibility but of their accumulated deductible, out of pocket payments and limits, co-pays and co-insurance, all of which have an impact on a patient’s financial responsibility. Digital solutions can quickly generate more comprehensive, timely estimates on which providers can base payment options and plans.
- Offer easy payment options. PayPal, GooglePay, ApplePay, e-checks, credit and debit card transactions should be among the payment options. AI tools can also quickly generate payment plans as well as prompt interventions such as financial counseling.
- Close the communications loop. Follow-up messages based on triggers can go out automatically in the patient’s preferred channel. Messages can range from encouraging a patient to complete the registration process to digital reminders about upcoming appointments.
- Make seamless transitions between physical and digital activities. When patients pre-register online, their data should be available and acted on at the point of care, analogous to how a traveler can buy an air ticket online and show a confirmation barcode at an airport kiosk to check in.
Modernizing the healthcare payment experience will increase access to care by helping patients understand the payment options right for their circumstances. In turn, by offering financial experiences competitive with those delivered by new industry players, providers should improve cash flow. To understand how much a modern financial experience could help strengthen financial flexibility, providers can multiply their annual net service patient revenue by 1 or 2 percent, the amount the National Association of Healthcare Access Management recommends providers collect before delivering services. For most providers, the results will make it clear that upgrading their patient financial experience is an initiative that will pay for itself and deliver lasting returns.