Hospitals, health systems and labs can tailor billing to help ease healthcare burden.
The COVID pandemic has had far-reaching social and economic impacts. The Pew Research Center calls special attention to how the pandemic is affecting women, saying, “Women generally earn less and save less, are the majority of single-parent households and disproportionately hold more insecure jobs in the informal economy or service sector with less access to social protections.” (Pew Research Center)
As the primary healthcare decision makers making 80 percent of all buying and usage decisions, women factor heavily into a vast majority of healthcare services as either patient or proxy. They also incur the greatest balance of healthcare costs. According to the U.S. Department of Labor, in 2015, women ages 19 to 44 incurred health expenses that were more than 80 percent higher than men in the same age group. Now, in the continuing pandemic economy, women are facing greater rates of unemployment than men. In May, the unemployment rate for women was 14.3% vs. 11.9% for men.
Finding ways to aid the most vulnerable patient populations both clinically and economically is a social and financial imperative for hospitals, health systems and labs.
The pandemic has accelerated a growing call from patient populations for greater price transparency and flexibility in billing. The goal for healthcare organizations is to achieve a balance that is more accommodating to patients while also increasing the likelihood of payment even among the most financially strained populations.
Broadly, a program should include:
Financial Policy Evaluation and Adjustment
Finding that balance begins with examining the existing financial policies and ensuring any Patient Assistance Programs account fully for an individual patient’s financial reality. During COVID-19, consideration must be given to the patient’s current income. Assessing financial need should not rely solely on the patient’s adjusted gross income from the previous year’s tax filing. A good program will also give patients options so they can best match the assistance to their personal situations. Options may include payment plans, prompt-pay discounts and scheduled credit card payments. As you explore the current financial policies, also consider unconventional practices. For example, engage sources in the community to identify additional funding options patients can pursue, such as co-payment foundations and patient advocacy services.
Staff Training and Patient Education
Staff will need to be trained both on the new financial policies, related changes in claim handling and how to talk with patients about their financial situations in a way that’s sensitive to the patient and aligned with the policies in place, so they can best accommodate the patient.
Revenue Cycle Optimization
The healthcare organization should engage its revenue cycle partner early in the overall process. Any program to accommodate a greater range of patient financial conditions, must begin with an optimized and tailored pre-registration process that confirms insurance eligibility and estimates out-of-pocket costs to the patient. RCM technology can be used to present estimated out-of-pocket costs along with financial assistance options, which can allow a patient to pre-qualify for assistance. Pre-qualified patient assistance encourages faster payment on balances due, which they can pay using an RCM-based patient portal. These types of RCM system-based patient access tools can speed up in-process claims handling, improve accuracy, and free up staff to deliver on patient engagement goals. Importantly, RCM tools also decrease risk of non-payment by providing electronic alerts and account statements along with expanded online payment options.
In the current environment, and perhaps as a permanent outgrowth of the pandemic, hospitals, health systems and labs will need to find ways to accommodate financially at-risk patients by offering tailored billing and payment options.
Quadax offers its clients a mix of advanced RCM technology and personalized service to tailor each solution to the unique needs of the client. Learn more about Quadax’s revenue cycle management solutions.